Optimization of the Therapeutic Approach to Patients with Sarcoma: Delphi Consensus
Table 2
Recommendations for first-line treatment.
Recommendation
Phase
Type of consensus (% agreement)
The first-line treatment of choice for metastatic disease is doxorubicin 75 mg/m2 administered as an IV infusion every 3 weeks
1
Yes (100)
The most important factors to consider when selecting the best first-line treatment for patients undergoing surgery for high-grade extremity STS with bilateral pulmonary metastases are as follows:
(i) Histological subtype
1
Yes (90)
(ii) Comorbidities, age, and ECOG performance status of the patient
1
Yes (90)
(iii) Potential for surgical treatment of the metastases
1
Yes (90)
(iv) Duration of progression-free interval
1
Yes (80)
The first-line treatment of choice for patients undergoing surgery for high-grade extremity STS with bilateral pulmonary metastases is as follows:
(i) Doxorubicin alone
1
Yes (90)
(ii) Doxorubicin + ifosfamide
1
Yes (75)
(iii) Surgical resection of the pulmonary metastases
1
Yes (75)
The treatment of choice for resectable high-grade myxoid liposarcoma of the thigh with M1 lung disease is chemotherapy with doxorubicin + ifosfamide
2
Yes (68.8)
Standard chemotherapy regimens are not recommended for patients with metastatic alveolar soft tissue sarcoma, given their limited activity; drugs that act against molecular targets, such as VEGFR inhibitors, should be used instead
1
Yes (75)
Enrollment in a clinical trial should always be considered for these patients
1
Yes (85)
The first-line treatment of choice for elderly female patients with metastatic uterine leiomyosarcoma should be the following:
