Conventional treatment for Soft Tissue Sarcoma

Good news. The overall survival rate for soft tissue sarcoma was 40 percent back in 1970 and is up to around 70 percent today. The general strategy employed consists of surgery, radiation and chemotherapy.

Surgery

Low-grade tumors are often removed via surgery alone. However, the resection must be complete and extensive. Traditionally, sarcoma of the extremities were addressed via amputation. Amputation is an effective but primitive treatment. Over the past decades, most treatment centers have been moving towards a more conservative surgical approach, leading to a decline in amputation.

Radiation

Aside from surgery, radiation is also commonly used. If negative (tumor free) margins cannot be established via surgical removal, radiation is often used to decrease the probability of local reoccurence.

Chemotherapy

Chemotherapy for sarcomas is still highly controversial. It hasn't been conclusively shown that chemotherapy provides significant benefit. The National Cancer Institute's current position on adjuvant chemotherapy reflects this. On their webpage, they states:

“Several prospective randomized trials have been unable to confirm conclusively whether doxorubicin-based adjuvant chemotherapy benefits adults with resectable soft tissue sarcomas. The majority of these studies accrued small numbers of patients and did not demonstrate a metastasis-free or an overall survival benefit for adjuvant chemotherapy. A quantitative meta-analysis of updated data from 1,568 individual patients from 14 trials of doxorubicin-based adjuvant therapy showed an absolute benefit from adjuvant therapy of 6% for local relapse-free interval (95% confidence interval [CI], 1–10), 10% for distant relapse-free interval (95% CI, 5–15), and 10% for recurrence-free survival (95% CI, 5–15); however, there was no OS benefit at 10 years".

 The standard chemotherapy drugs used for soft tissue sarcomas are doxorubicin and ifosfamide.

Here are some papers of interest regarding Ifosfamide: