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.