The first chemotherapy study of soft tissue sarcoma (STS) by the Scandinavi
an Sar-coma Group was started in 1981 (SSG I). It evaluated the single agen
t adjuvant doxorubicin in a randomized setting in patients with high-grade
STS. No improvement was noted in the overall survival or disease-free survi
val rate. More intense chemotherapy was thereafter (1991-1994) evaluated in
a phase 2 study, introducing ifosfamide and a continuous infusion of etopo
side with growth factor (SSG X). The response rate of previously untreated
patients was high (42%), but complete remissions were few. Analysis of pati
ents undergoing surgery after preoperative chemotherapy suggested an increa
sed survival. A recent meta-analysis of adjuvant chemotherapy for localized
resectable STS in adults, including the SSG I trial, indicated a batter di
sease-free survival and possibly improved overall survival (Thierny et al.
1997). At present, we are studying whether such a benefit can be shown inpa
tients with high-risk prognostic criteria by giving adjuvant ifosfamide and
doxorubicin treatment after primary surgery (SSG XIII). In the latter SSG
study, started on July 1, 1998, the adjuvant therapy is evaluated in a phas
e 2 study in selected patients with high-grade STS and other unfavorable pr
ognostic factors.