<b>Other Systemic Treatment</b>


<b>Chemotherapy
With leiomyosarcoma, chemotherapy is best saved for neoadjuvant treatment, or for inoperable metastases that are potentially life threatening, </b>such as lung, liver, or brain.  In these situations, judicious use of selected chemotherapy with bone marrow support has increased survival time. 

One would not recommend using chemotherapy for LMS bone metastases.  The major problems from bone metastases -- skeletal/vertebral instability, pain, hypercalcemia -- can all be managed effectively with surgical, radiological, and/or other drug interventions.  Chemotherapy is not a necessity.  And you will want to preserve the chemotherapy options you do have for life-threatening situations, where many other options may not abound.

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<b>Hormones</b>
The aromatase inhibitors seem to be more effective and better tolerated than the older agents, megestrol acetate and aminoglutethimide.  Whether estrogen receptor positive LMS will respond to their use is not known.  Certainly use of some of the aromatase inhibitors would increase the tendency toward osteoporosis. <b> Bone metastases grow sooner and better in osteoporotic bone.</b>

Androgen blockage [LHRH + antiandrogen] has been useful in prostate cancer, but it is unknown whether androgen hormone receptor positive LMS would respond to this.  As well as the possible osteoporotic effect on bone mass.

<b>For further information &&url</b>


compiled/written by doctordee
with thanks to Lynette and Laura 
June 2002  
updated December 2003
