Systemic Treatment of Advanced or Metastatic Soft Tissue Sarcomas

Abstract

Adequate local treatment of soft tissue sarcomas has always been difficult in view of the local recurrence rate of 40 to 80% [1]. Most of these relapses occur within 3 years [2]. The use of sophisticated surgical techniques and the addition of postoperative high-dose radiotherapy have considerably reduced the number of local recurrences in extremity lesions [2, 3, 4, 5]. Unfortunately, the inability to apply the required high doses of irradiation precluded a similar decrease in local recurrence in truncal lesions after surgery. Early hematogeneous spreading, most frequently to the lungs, is characteristic for soft tissue sarcomas and apparently can only in part be prevented by optimal local control of the primary tumor. Therefore, distant metastases still occur in a considerable number of patients for whom systemic treatment will be considered. This chapter summarizes the present achievements with systemic treatment of advanced soft tissue sarcomas.