Chemotherapy for Soft Tissue Sarcomas

Chemotherapy (chemo) is treatment with anti-cancer drugs. These drugs are given by vein or by mouth to treat some people with soft tissue sarcomas.

When is chemo used?

Depending on the type and stage of sarcoma, chemotherapy might be given as the main treatment or after surgery. Different types of sarcomas respond better to chemo than others. A combination of several chemo drugs is generally used to treat soft tissue sarcomas.

Chemo drugs used for soft tissue sarcomas

The most common chemo drugs used are:

• Ifosfamide (Ifex^®): Given with mesna (not a chemo drug) to protect the bladder from toxic side effects
• Doxorubicin (Adriamycin^®)

Other chemo drugs might be used as well, including:

• Liposomal Doxorubicin (Doxil)
• Dacarbazine (DTIC)
• Epirubicin (Ellence)
• Temozolomide (Temodar^®)
• Docetaxel (Taxotere^®)
• Gemcitabine (Gemzar^®)
• Vinorelbine (Navelbine^®)
• Trabectedin (Yondelis^®)
• Eribulin (Halaven^®)

When several drugs are used together, the combination is given a shortened name such as: AIM (Adriamycin [doxorubicin], ifosfamide, and mesna) or Gem-Tax (gemcitabine and docetaxel).

Isolated limb perfusion (ILP)

ILP is a different way to give chemo. The circulation of the limb (arm or leg) with the tumor is separated from the rest of the body. Chemo is then given just to that limb. Sometimes the blood is warmed up a bit to help the chemo work better, a method called hyperthermia.

ILP might be used to treat tumors that cannot be removed or to treat high-grade tumors before surgery. It can help shrink tumors, but it isn’t clear that it helps patients live longer than standard chemo. ILP should only be done at centers with a lot of experience giving chemo this way.

Possible side effects

Chemo drugs kill cancer cells but also damage some normal cells. This causes side effects. Side effects depend on the type of drugs, the amount taken, and the length of treatment. Common chemo side effects include:

• Nausea and vomiting
• Loss of appetite
• Loss of hair
• Mouth sores
• Fatigue
• Low blood counts

Because chemotherapy can damage the blood-producing cells of the bone marrow, patients might have low blood cell counts. This can result in:

• Increased chance of infection from too few white blood cells
• Problems with bleeding or bruising from too few blood platelets
• Fatigue and weakness from too few red blood cells

Most side effects go away over time once treatment is stopped. For instance, hair will grow back after treatment ends, but it might look different. There are treatments for many of the short-term side effects of chemo. For instance, drugs can be given that prevent or reduce nausea and vomiting.

Possible long-term side effects

Some chemo side effects can last a long time or even be permanent. For instance, doxorubicin can weaken the heart if too much is given. If you're going to get this drug, your doctor might check your heart function with special studies before starting this drug. The doctor will also check your heart function during therapy.

Some chemo drugs cause nerve damage, called neuropathy, leading to numbness, tingling, or even pain in the hands and feet.

Chemotherapy might also permanently damage ovaries or testicles, causing infertility (not being able to have children). For more information, see Fertility Problems.