Introduction Mechanism induces apoptosis may target specific proteins over-expressed in cancer cells e.g. tyrosine kinase inhibitors login to view 3 more bullets eliminates micrometastasis in lungs >98% necrosis with chemotherapy is good prognostic sign Resistance expression of multi-drug resistance (MDR) gene portends very poor prognosis cells can pump chemotherapy out of cell present in 25% of primary lesions and 50% of metastatic lesions Indications Integral component of treatment along with surgical resection in osteosarcoma (intramedullary and periosteal) Ewing's sarcoma/primative neuroectodermal tumor malignant fibrous histiocytoma dedifferentiated chondrosarcoma chemotherapy for soft tissue sarcoma is controversial Administration Preoperative chemotherapy given for 8-12 weeks Maintenance chemotherapy for 6-12 months Specific Agents & Antidotes Doxorubicin (Adriamycin) mechanism doxorubicin is an anthracycline antibiotic commonly used in oncological protocols functions as a cytostatic agent side effects cardiac toxicity login to view 2 more bullets Agents and Antidotes mechlorethamine/cisplatin - give sodium thiosulfate doxorubicin/epirubicin - give dexrazoxane vinca alkaloids (vincristine/vinblastine) - give hot compress and hyaluronidase give cold compress for all other vesicants