Using single-agent therapy in adult patients with advanced soft tissue sarcoma can still be considered standard care
Using single-agent therapy in adult patients with advanced soft tissue sarcoma can still be considered standard care
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DOI：
10.1634/theoncologist.10-10-833
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发表时间：
2005-11-01
期刊：
影响因子：
5.8
通讯作者：
Verweij, J
中科院分区：
文献类型：
--
作者：
Sleijfer, S;Seynaeve, C;Verweij, J
成人软组织肉瘤是一组异质性的肉瘤，有40多种不同的亚型。虽然局部治疗仍然是局部疾病的主要手段，但全身化疗在晚期软组织肉瘤的治疗中有重要作用。对于转移性疾病患者，化疗在绝大多数情况下是一种姑息治疗。在这种情况下，毒性不应超过化疗的潜在益处。对于局部晚期疾病过于广泛而无法进行局部治疗的患者，全身化疗有助于治愈，前提是肿瘤缩小使随后的最佳局部治疗成为可能。在这些情况下，应使用产生最高反应率的化疗方案。在过去的几十年里，一些随机研究的目的是确定联合治疗方案是否在缓解率和总生存率方面优于单药治疗。本文综述了目前关于成人软组织肉瘤（不包括胃肠道间质瘤、尤文样肉瘤和其他小蓝圆细胞肿瘤）化疗的现有数据。此外，人们越来越认识到，软组织肉瘤的未来研究应侧重于识别可作为治疗靶点的肿瘤因子，并且应单独分析不同肿瘤亚型对全身治疗的敏感性。这篇综述还重点介绍了这些和其他策略，这些策略有望在不久的将来在这种疾病中取得更好的结果。
The group of soft tissue sarcomas in adult patients is a heterogeneous group with more than 40 different subtypes. While local treatment remains the mainstay for localized disease, systemic chemotherapy can importantly contribute in the treatment of advanced soft tissue sarcoma. For patients with metastatic disease, chemotherapy is a palliative treatment in the vast majority of the cases. In this setting, toxicity should not outweigh the potential benefits resulting from chemotherapy. In patients with locally advanced disease too extensive for local treatment, systemic chemotherapy can contribute to cure, provided that tumor shrinkage renders subsequent optimal local treatment possible. In these cases, chemotherapeutic regimens yielding the highest response rates achievable should be used. In the last decades, several randomized studies have aimed to determine whether combination regimens yield benefit over single-agent treatment in terms of response rate and overall survival. This review addresses the current available data on chemotherapy for adult patients with soft tissue sarcoma, excluding gastrointestinal stromal tumor, the Ewing-like sarcomas, and other small blue round cell tumors. In addition, it is increasingly recognized that future research in soft tissue sarcoma should focus on the identification of tumor factors that can serve as targets for treatment and that the diverse tumor subtypes should be analyzed separately for their sensitivity to systemic treatment. This review also focuses on these and other strategies that will hopefully lead to better outcomes in this disease entity in the near future.