Treatment of soft tissue and bone sarcomas: review of studies at the National Cancer Institute.
The Surgery Branch of the National Cancer Institute conducted two prospective trials on the effectiveness of adjuvant chemotherapy in the treatment of patients with sarcomas. Adriamycin and cyclophosphamide (Cytoxan) appeared to improve significantly the disease-free survival of 55 current protocol patients with sarcomas of soft tissue compared with historical controls (P less than 0.001). The high incidence of drug-induced cardiomyopathy associated with this regimen led us to begin a prospective randomized trial of this adjuvant chemotherapy in patients with sarcomas of soft tissue. The use of high-dose methotrexate following surgery in 50 patients with osteogenic sarcoma was associated with a small increase in disease-free survival (P = 0.028) compared with historical controls. Little if any effect was seen in patients with high-grade lesions (P = 0.11). Overall survival of patients with osteogenic sarcoma was dramatically improved (P less than 0.001), probably due to the introduction of frequent screening for pulmonary metastases and the surgical resection of these metastases as soon as they appeared.
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001859:Bone Neoplasms / Q000401:mortality / Q000628:therapy*; D009202:Cardiomyopathies / Q000139:chemically induced; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D009316:National Institutes of Health (U.S.); D012516:Osteosarcoma / Q000628:therapy*; D011446:Prospective Studies; D011897:Random Allocation; D012509:Sarcoma / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000628:therapy*; D014481:United States
D000970:Antineoplastic Agents; D008727:Methotrexate