BACKGROUND Evaluation of the primary effects and acute adverse reactions of combined chemo-radiation and hyperthermia for patients with locally advanced soft tissue sarcoma. MATERIALS AND METHODS Eight patients with locally advanced soft tissue sarcoma underwent a combination of radiation therapy, continuous infusion of doxorubicin, and once weekly hyperthermia. RESULTS Complete response was obtained in 2 patients and partial response in 3. Level 4 skin reaction was developed in 4 patients who had superficially located tumour. Treatment interruption more than three days was required in only one patient who developed level 4 pharyngitis. Five patients developed grade 3 leukopenia, 2 had grade 4 leukopenia requiring administration of haematopoietic growth factor. Two patients developed radiation pneumonitis which required steroid medication. No symptomatic cardiotoxicity was observed. There was no acute morbidity during the treatment. CONCLUSIONS The intensive combination therapy provided good local responses or at least palliation for most of the patients entered without increasing treatment morbidity.