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Townsend, C. , Eilber, F. , Morton, D. : Skeletal and soft tissue sarcomas: results of surgical adjuvant chemotherapy. Proc. Am. Soc. Clin. Onc. 17, 265-270 (1976) 20. : Enterale und parenterale Leucovorin-Medikation nach MethotrexatStof3behandlung maligner Tumoren. Med. Klinik 71, 1720-1723 (1976) 21. : Dihydrofolat-Reduktase und Thymidin-Kinase im Knochenmark unter Einwirkung von Foisaureantagonisten. Klin. Wochenschr. 45, 987-994 (1967) 22. : DNS-Synthese in Leukamiezellen unter der Einwirkung von Methotrexat, 5-Fluoro-Uracil und Cytosin-Arabinosid in vitro.
Five others of this group remain disease-free after 21 + to 48+ months. In the second series all four patients remain disease-free after 1+-14+ months. Figure 1 shows the actuarial analysis of diseasefree survival for the total series of 19 patients. The present findings indicate that amputation followed by intermittent treatment with the maximum tolerated doses of ADM has not significantly improved the 2-year relapse rate over that obtained with surgery alone. Only a moderate increase in the disease-free status was achieved, and our results appear definitely inferior to those reported by other authors utilizing ADM as adjuvant therapy .
The results of protocol B are better and seem comparable to the results published by CORTES et al. We have not enough patients to determine whether the semicontinuous chemotherapy has had any additional beneficial effects. However, even for protocol B, the overall results are not fully satisfactory, considering that we have a maximum of2 years follow-up and that the risk oflate metastases persists. The tolerance and toxic cost of protocol A is also not negligible and was ascribed mainly to the use of high-dose methotrexate.