CHEMOTHERAPY FOR METASTATIC SOFT-TISSUE S ARCOMAS

The chemosensitivity of bone sarcomas contrasts sharply with the compa rative initial chemoresistance of soft tissue sarcomas. The lack of ne w effective cytotoxic agents, delayed treatment due to a clinical pres entation which is often innocuous and the absence of a consensus about the role of adjuvant chemotherapy after adequate surgery account for the slow progress achieved in the treatment of these rumours and for s uch an appalling prognosis, Chemotherapy is still purely palliative ex cept for certain specific metastatic lesions, and median overall survi val is more often than not below 12 months. However, the optimization of the therapeutic index of the most active antimitotic drugs, the eve r-increasing acceptance of the concept of a dose-effect for the majori ty of these lesions, the particularly promising objective response rat es with intensive drug combinations and a better understanding of the development process of certain lesions and histologic subtypes make it possible to envisage a rapid improvement in their still far too disma l prognosis.