Adjuvant therapy of soft-tissue sarcomas

P. C. McGrath, D. A. Sloan, D. E. Kenady

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Combination surgery and radiation therapy is currently the standard of care for primary treatment of soft-tissue sarcomas. The practice of complete muscle group excision has been replaced by that of achieving a 3- to 4-cm circumferential margin or adding either pre- or postoperative radiation to the surgical therapy. The surgeon can limit the margins to preserve the optimum tissue function but at the same time achieve maximum local control. Investigations continue to define the role of brachytherapy. Achieving therapeutic radiation doses while significantly limiting the treatment time has obvious advantages. Failure to irradiate a field wide enough, however, could result in marginal relapses. The demonstration of Brennan et al that the very high complication rate associated with this technique can be limited by delaying the delivery of radiation through the surgically placed catheters until 5 days after a surgical resection has significant implications for further protocols. The role of adjuvant chemotherapy in the multimodal management of patients with soft-tissue sarcomas is still investigational. Although a few of the randomized trials showed definite disease-free and overall survival benefit in those patients receiving adjuvant chemotherapy, most did not. In general, many authors believe that adjuvant chemotherapy for soft-tissue sarcoma cannot be recommended outside the context of a clinical trial. As previously mentioned, current adjuvant trials are attempting to define biologic parameters that may influence future randomized studies. Also, the identification of active new agents such as ifosfamide will allow significant clinical trials to take place, helping to better define the role of chemotherapy in the neoadjuvant setting in patients who are at high risk for recurrence.

Original languageEnglish
Pages (from-to)21-29
Number of pages9
JournalClinics in Plastic Surgery
Issue number1
StatePublished - 1995

ASJC Scopus subject areas

  • Surgery


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