Treatment of advanced soft tissue sarcoma

  There are many classifications of soft tissue sarcomas, in fact they are of broad origin, can develop in mesenchymal cells throughout the body, and have different cell morphology and different response to treatment, some tumors are not sensitive to chemotherapy. Therefore, before treatment, it is necessary to study the pathological diagnosis, consult if necessary, and come up with the correct classification and typing. If conditions are available, it is necessary to contact with experts in this field to perform some research-based examinations and choose the appropriate treatment plan. The treatment of advanced soft tissue sarcoma is palliative in most patients, and surgical resection can prolong the relapse-free survival.  For soft tissue sarcoma that is inoperable in advanced stage, if there are clinical trials of new drugs, it is recommended that patients can consider participating because the effect of common chemotherapy is not good.  3.For asymptomatic low-grade malignant tumors, the response to chemotherapy is poor. It is recommended to postpone chemotherapy as much as possible, closely monitor the disease progress, and then treat if the progress is rapid or the lesion endangers organ function or life.  4. Histological types that are sensitive to chemotherapy, such as synovial sarcoma, myxoid liposarcoma, leiomyosarcoma, high-grade pleomorphic unclassified sarcoma, can be considered for early chemotherapy. The early chemotherapy can be considered.  For angiosarcoma angiosarcomas, paclitaxel taxane, or pegylated liposomal doxorubicin monotherapy can be applied.  6, alveolar soft parts sarcoma, solitary fibrous tumor, hemangiopericytoma, and clear cell sarcoma, recommend sotane-sunitinib or participate in clinical trials.  7. For perivascular epithelioid cell differentiation (PEComa), including angiomyolipoma/lymphangioleiomyomatosis, sirolimus therapy is recommended. The recommended treatment is sirolimus.  8, non-GIST suitable for imatinib treatment, there are pigmented villonodular synovitis villonodular synovitis/tenosynovial giant cell tumor. 9, other cell types, the general application of chemotherapy such as, preferred adriamycin and isocyclophosphamide based Chemotherapy, followed by some tumors such as smooth muscle sarcoma leiomyosarcoma or unclassified tumors can be selected as Kenzyme plus doxorubicin regimen chemotherapy.  10. If the above mentioned tumors progress after the above recommended first-line treatment, pazopanib can be chosen as second-line treatment, as a level 1 recommendation.