Administration of indomethacin caused complete resolution of a desmoid tumor after a partial response to radiation. In another patient, this drug caused an immediate response, then became ineffective. When large doses of ascorbic acid were given with indomethacin, slow resolution of the tumor began and has continued for 14 months. Treatment of a third case with indomethacin and ascorbic acid from the beginning produced shrinkage of the tumor which has continued to date.
One hundred fifty-five adult patients with "operable" soft part sarcomas including rhabdomyosarcoma, liposarcoma, leiomyosarcoma and fibrosarcoma of the trunk and extremities are reviewed. Local recurrences of 93% and 60% occurred after local and wide excisions of the primary tumor. In this series of patients, amputation was the most efficient procedure for controlling the primary site. The absolute 5 and 10-year survival rates for all groups of tumors were 50% and 26%. Development of a second primary tumor of a different cell type occurred in 9% of the patients. Local recurrence, single distant metastasis, and/or second primary tumors should be considered potentially curable and appropriate surgical and/or radiation therapy carried out.
Of 34 cases with synovial sarcoma, the five-year survival rate was 36%. A high local recurrence rate results when local excision is performed. Wide excision which may necessitate amputation is the treatment of choice. Prophylactic and even therapeutic node dissections are ineffective in increasing survival because of the disease. Evaluation of radiation therapy was impossible, although some patients obtained significant paliation. Adriamycin appears to have a tumoricidal effect and provided clinically significant responses in several patients.
Eighty-eight patients with disseminated melanoma and 22 patients with various other solid tumors were treated with combination chemotherapy consisting of DTIC, at a fixed dose, with either adriamycin, CCNU, or hydroxyurea, at several dosages. An objective response rate of 20 % was observed in 84 evaluable melanoma patients. The addition of the other agents to DTIC did not provide enhanced antitumor activity. Combination chemotherapy increased toxicity. Encouraging objective responses were observed in patients with synovial sarcoma (4/7) and teratocarcinoma of the testis (1/1) treated with the combination of adriamycin and DTIC.
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