The Management Of Localized soft tissue sarcomas has evolved over the last several years resulting in improved functional status and overall outcome, however, progress in metastatic disease has been less than impressive. Adriamycin and DTIC based chemotherapy programs have resulted in response rates of upto 50 percent with a small but finite cure fraction, especially in conjunction with surgical resection of residual abnormalities. The decade of the 80's experienced a considerable amount of residual abnormalities. The decade of the 80's experienced a considerable amount of enthusiasm in re-exploring the role of Ifosfamide and mesna, and identified its definite usefulness as an effective salvage regimen with response rates of approximately 2530 percentage in Adriamycin failures. Studies evaluating the role of Ifosfamide as a front line agent in combination with Adriamycin have met with increased toxicities without a significant additive or synergistic therapeutic benefit, probably due to compromised dose intensity of each individual agents. The theoretical rationale for the use of high-dose chemotherapy in sarcomas is based on the linear dose response relationship of alkylating agents and Adriamycin. Such an approach has now become feasible with the advent of growth factors and/or peripheral blood progenitor cell reinfusions fore bone marrow support. While these approaches seem promising in its infancy, with improved complete and overall responses, survival benefit is yet to be accomplished. The limited experience available in the literature with even more aggressive approaches like myeloablative doses of chemotherapy followed by autologous bone marrow transplantation, have been uniformly disappointing, with extremely short lived responses and lack of prolongation of overall survival, significant morbidity and cost. As clinical research continues to improve our understanding and ability to implement the currently available therapeutic armamentarium, the search for newer and better drugs needs to continue. Patients should be encouraged to enroll in research protocols, if we are to answer relevant questions and hopefully impact on this otherwise lethal problem.

152 patients with Gestational Trophoblastic Disease (G T D) were treated at Department of Medical Oncology, Government Hospital for Women/Institute of Obstetrics & Gynaecology, Chennai; from August 1988 to June 1996. Of the 152 patients, 71 (46.5 percent) were followed up for Hydatiform Moles (HM), 44 (29 percent), 15 (10 percent) and 22 (14.5 percent) were treated for Persistent Molar Disease (PMD), Invasive mole (IM) and Choriocarcinoma respectively. Forty five (29.6 percent) were 20 years of age, 101 (66.4 percent) were between 21 and 39 years of age and 6 (4 percent) were 40 years of age. Treatment results show 100 percent complete remission (CR) rates in patients with Persistent Molar Disease and Invasive Mole, 50 percent and 75 percent CR rates in metastatic and non-metastatic choriocarcinoma respectively. Chemotherapy was the main form of treatment. Adjuvant hysterectomy and radiotherapy had been used in selected patients. There were 48 pregnancies in patients followed up, resulting in 40 live births and 4 cases of Repeat Moles have been noted.

Intracranial Hodgkin's Disease is a rarity. It is usually seen with progressive, resistant and recurrent systemic disease. In the present case report, intracranial involvement was seen along with systemic disease as a primary presentation which is really rare. Combined modality approach with aggressive chemotherapy with cranial radiotherapy is the mode of treatment advised in these patients which is found to be useful. The intention of the treatment should be cure and not only palliation in these patients.

The occurrence of a second malignancy is one of the most devastating late effect of chemotherapy often associated with a high rate of morbidity and mortality. Cumulative probability has been estimated to be about 3-12 percent. Both radiotherapy and chemotherapy have been implicated in the development of second malignancies. Alkylating agents are associated with the highest risk. We report here a case of ANLL developing 4 years after treatment for Stage II-B (INSS) neuroblastoma.