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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
"e"
symptom
allergic bronchopulmonary aspergillosis
aromatase deficiency
cadasil
child syndrome
dracunculiasis
gm1 gangliosidosis
inclusion body myositis
kallmann syndrome
krabbe disease
neonatal adrenoleukodystrophy
pleomorphic liposarcoma
pyomyositis
trochlear dysplasia
wolf-hirschhorn syndrome
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