Adjuvant Chemotherapy Following Complete Resection of Soft TissueSarcoma in Adults: A Clinical Practice Guideline

[摘要] Purpose.To review the literature and make recommendations for the use of anthracycline-based adjuvant chemotherapy inadult patients with soft tissue sarcoma (STS).Patients.The recommendations apply to patients >15 years old with completely resected STS.Methods.A systematic overview of the published literature was combined with a consensus process around the interpretationof the evidence in the context of conventional practice to develop an evidence-based practice guideline.Results.Four meta-analyses and 17 randomized clinical trials comparing anthracycline-based adjuvant chemotherapy versusobservation were reviewed. The Sarcoma Meta-Analysis Collaboration (SMAC) was the best analysis because it assessedindividual patient data and had the longest follow-up. The results of the SMAC meta-analysis together with data from morerecently published randomized trials, as well as our analysis of the toxicity and compliance data, are incorporated in thissystematic review.Discussion.It is reasonable to consider anthracycline-based adjuvant chemotherapy in patients who have had removal of asarcoma with features predicting a high likelihood of relapse (deep location, size >5 cm, high histological grade). Althoughthe benefits of adjuvant chemotherapy are most apparent in patients with extremity sarcomas, patients with high-risktumours at other sites should also be considered for such therapy.

[学科分类] 肿瘤学