Treatments for stage 4 soft tissue sarcoma

The following are treatment options for stage 4 (metastatic or advanced) soft tissue sarcoma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Find out more about metastatic cancer.


Chemotherapy is usually offered for stage 4 soft tissue sarcoma. It is used to help control the growth and spread of the cancer because surgery can’t be done in most cases. Chemotherapy is also used to relieve symptoms of advanced cancer.

Chemotherapy is most often the first treatment. It may be used along with radiation therapy. Doxorubicin is the standard chemotherapy drug used and it is usually given alone. It may be given in combination with ifosfamide (Ifex). Other chemotherapy drugs can be used if doxorubicin doesn’t work.

Targeted therapy

You may be offered targeted therapy for stage 4 soft tissue sarcoma. It is used to help stop the cancer cells from growing, dividing and spreading.

Pazopanib (Votrient) may be offered after chemotherapy for some types of soft tissue sarcoma. It is used when chemotherapy has already been given or the soft tissue sarcoma continues to grow within one year after treatment.

Radiation therapy

You may be offered radiation therapy for stage 4 soft tissue sarcoma when surgery can’t be done. External radiation therapy is most often used. It is given alone or in addition to chemotherapy.

Stereotactic body radiation therapy (SBRT) may be used to treat lung metastases when there are only a few small tumours and surgery can’t be done. In certain cases, it may be used to treat metastases outside the lungs.

If surgery can’t be done (the cancer is unresectable), sometimes giving radiation therapy with or without chemotherapy first can make surgery possible.


You may be offered surgery for stage 4 soft tissue sarcoma, but it is not common. Most often, surgery is used to control symptoms caused by the cancer rather than to treat the cancer itself.

In rare cases, surgery with wide local excision may be done to remove all of the cancer, including the metastases, when the cancer has only spread to a few places in the lungs.

Surgery for other types of metastases may be possible in certain cases.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Talk to your doctor about clinical trials open to people in Canada with soft tissue sarcoma. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references