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[Indication of chemotherapy according to histological type of musculoskeletal sarcomas].
[pleomorphic liposarcoma]
In
high
-grade
musculoskeletal
sarcomas
,
adjuvant
chemotherapy
is
often
performed
to
prevent
distant
metastases
.
As
the
efficacy
of
chemotherapy
varies
according
to
the
histological
type
of
sarcoma
,
its
indication
is
determined
according
to
the
histological
type
and
the
stage
.
Prognoses
are
poor
in
patients
with
osteosarcoma
,
Ewing
's
sarcoma
,
or
rhabdomyosarcoma
,
when
surgery
alone
is
performed
.
However
,
because
these
sarcomas
are
chemosensitive
,
their
prognoses
are
improved
with
adjuvant
chemotherapy
,
so
it
is
absolutely
necessary
.
Drugs
commonly
used
for
osteosarcoma
include
adriamycin
,
cisplatin
,
methotrexate
,
vincristine
,
and
ifosfamide
.
For
Ewing
's
sarcoma
and
rhabdomyosarcoma
,
vincristine
,
actinomycin-
D
,
cyclophosphamide
,
etoposide
,
and
ifosfamide
are
commonly
used
.
On
the
other
hand
,
the
efficacy
of
chemotherapy
is
unclear
in
most
of
the
non-
round
cell
sarcomas
,
e
.
g
.
,
malignant
fibrous
histiocytoma
,
pleomorphic
liposarcoma
,
and
leiomyosarcoma
,
so
adjuvant
chemotherapy
is
relatively
indicated
and
often
performed
preoperatively
.
The
efficacy
is
evaluated
by
reduction
of
the
tumor
volume
as
a
surrogate
marker
.
Postoperative
chemotherapy
is
performed
when
the
preoperative
chemotherapy
is
effective
.
Nowadays
,
several
kinds
of
antitumor
agents
are
usually
used
for
non-
round
cell
sarcomas
,
and
many
authors
have
reported
various
kinds
of
regimens
and
their
clinical
results
.
Among
them
,
the
key
drugs
are
adriamycin
and
ifosfamide
.
Recently
,
taxanes
and
gemcitabine
are
sometimes
used
.
For
chemoresistant
sarcomas
,
e
.
g
.
,
chondrosarcoma
,
chordoma
,
alveolar
soft
part
sarcoma
,
chemotherapy
is
rarely
indicated
,
even
if
the
tumor
is
histologically
high
grade
and
large
.
Low
-grade
musculoskeletal
sarcomas
,
e
.
g
.
,
low
-grade
chondrosarcoma
,
central
low
-grade
osteosarcoma
,
parosteal
osteosarcoma
,
well-differentiated
liposarcoma
,
and
dermatofibrosarcoma
protuberans
,
are
well
cured
only
by
surgical
excision
,
and
adjuvant
chemotherapy
is
therefore
not
indicated
.
Superficially-located
,
small
-size
non-
round
cell
sarcomas
,
even
though
histologically
high
grade
,
are
well
healed
only
by
surgical
excision
,
and
adjuvant
chemotherapy
is
rarely
indicated
.
Diseases
Validation
Diseases presenting
"low-grade musculoskeletal sarcomas"
symptom
pleomorphic liposarcoma
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