Chemotherapy for soft tissue sarcoma

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to treat soft tissue sarcoma. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is given for different reasons. You may have chemotherapy to:

• destroy cancer cells left behind after surgery, especially when there is a high risk that the cancer will come back (recur) (called postoperative or adjuvant chemotherapy)
• shrink a tumour before surgery and help make surgery easier (called preoperative or neoadjuvant chemotherapy)
• control the growth and spread of advanced soft tissue sarcoma
• control the symptoms of advanced soft tissue sarcoma (called palliative chemotherapy)

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the blood to reach and destroy cancer cells all over the body, including those that may have broken away from the tumour.

The most common chemotherapy drug used to treat soft tissue sarcoma is doxorubicin. It is usually given alone as the standard first-line chemotherapy. Sometimes ifosfamide (Ifex) is used alone or in combination with doxorubicin.

Mesna (Uromitexan) is given at the same time as ifosfamide. It is a supportive drug used to protect the bladder from damage and lower the risk of urinary tract problems caused by the chemotherapy.

If soft tissue sarcoma does not respond to drugs used in earlier treatments or if it comes back, other chemotherapy drugs may be used. Also, some specific types of soft tissue sarcoma seem to be more sensitive to certain chemotherapy drugs. Some of the other chemotherapy drugs used alone or in combination include:

• gemcitabine – mainly for leiomyosarcoma and angiosarcoma
• docetaxel
• trabectedin (Yondelis) – for metastatic liposarcoma and leiomyosarcoma
• dacarbazine – mainly for leiomyosarcoma
• epirubicin
• paclitaxel – especially for angiosarcoma
• eribulin (Halaven) – for liposarcoma

Chemotherapy for soft tissue sarcoma is most often given through a needle into a vein (intravenously). It is usually given for a few days every 3 weeks. How often and how long chemotherapy is given depends on the type of drug or drug combination used. It is usually given for several months.

Side effects can happen with any type of treatment for soft tissue sarcoma, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Some common side effects of chemotherapy drugs used for soft tissue sarcoma are:

• nausea and vomiting
• loss of appetite
• sore mouth and throat
• hair loss
• fatigue
• low blood cell counts
• heart problems
• numbness or tingling of the fingers and toes

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.