Diagnosis and treatment of soft tissue sarcomas in adults.
Our knowledge of the molecular biology of sarcomas has progressed considerably over the past year, with major emphasis on the role of p53 and MDM2 gene mutations. Further studies on drug resistance mechanisms and the role of MDR1 expression in sarcomas have been reported. The investigations using different imaging techniques as ways of predicting tumor necrosis more accurately than our current response measurements after therapy have led to promising results. The many clinical phase II studies with new drugs led to the identification of taxotere as a new active agent against soft tissue sarcomas. Similar impressive results, such as those obtained with isolated limb perfusion in melanoma, have been reported in limb sarcomas with an identical regimen. The activity of ifosfamide in pretreated patients, administered at an increased dose, is suggestive of dose dependency. The improved results in phase II studies of dose-intensive chemotherapy with the support of colony-stimulating factors are encouraging and these regimens are now being investigated in the adjuvant setting.
Dirix
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Department of Oncology, University Hospital Antwerp, Edegem, Belgium.
Van Oosterom
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D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018432:Drug Resistance, Multiple; D005060:Europe / Q000453:epidemiology; D015972:Gene Expression Regulation, Neoplastic; D016158:Genes, p53; D006540:Herbicides / Q000009:adverse effects; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use; D016864:Li-Fraumeni Syndrome / Q000235:genetics; D009363:Neoplasm Proteins / Q000235:genetics; D009381:Neoplasms, Radiation-Induced; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D012509:Sarcoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000628:therapy
D000970:Antineoplastic Agents; D006540:Herbicides; D007155:Immunologic Factors; D009363:Neoplasm Proteins