Chemotherapy of soft tissue sarcomas with Cyclophosphamid or Ifosfamid, Adriamycin and DTIC (CAD or IAD) preoperatively and in patients with metastatic disease : a non randomized pilot study

Soft tissue sarcomas are rare tumors, in localized disease most authors report a five year survival between 40 and 60%. Patients with soft tissue sarcomas mostly present with their primary tumors; they can be rendered disease free clinically by wide resection. Since local recurrences and metastases, especially in grade II and III soft tissue sarcomas over 5 cm in size are a major therapeutic problem, combined modality treatment with radiotherapy and adjuvant chemotherapy is evaluated in prospective studies. Limb sparing procedures without jeopardizing the result may be used, if they are associated with radiotherapy and chemotherapy (Eilber 1980, Consensus Conference 1985, Eilber 1990). Several chemotherapeutic agents, most recently Ifosfamid was added to the list, are found to be effective; among the most promising regimes were Cyclophosphamid, Adriamycin, DTIC (CAD, Blum 1980) and in recent years Ifosfamid, Adriamycin, DTIC (IAD, Elias 1989).