Adjuvant chemotherapy of soft‐part sarcomas with ALOMAD (S4)

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Abstract
Sixty‐four adult patients with soft‐tissue sarcomas received adjuvant chemotherapy with a six‐drug combination regimen after surgery. Seventy percent remain free of disease with a median follow‐up of 50 months. Only seven patients have died of their disease, all within the first 24 months after surgery. Most patients experienced severe nausea and vomiting secondary to the actinomycin D and dacarbazine parts of the protocol, and three patients experienced frank Adriamycin cardiomyopathy. Toxicity from this combination was otherwise mild. The 58% recurrence rate of 12 patients who discontinued therapy early because of nausea was significantly greater than the 23% rate for those who completed or relapsed on therapy (P = 0.01). Adjuvant chemotherapy should be considered after surgery for patients with soft‐part sarcomas, especially those with high‐grade tumors that have a considerable risk of recurrence.