title: A prospective randomized evaluation of three schedules of mesna administration in patients receiving an ifosfamide-containing chemotherapy regimen: sustained efficiency and simplified administration.
abstract: Chemotherapy with oxazaphosphorines, such as ifosfamide, is often limited by unacceptable urotoxicity. Without uroprotection hemorrhagic cystitis becomes dose-limiting. Mesna, a thiol compound, is a drug able to bind the toxic metabolites, forming nontoxic compounds in the urine. A total of 122 patients were enrolled in this study and 228 chemotherapy cycles with an ifosfamide-containing regimen were performed (225 evaluable). Mesna was given at the same total dose as the ifosfamide in all arms. On arm A, mesna was given i. v. in equal doses 15 min before and 4 h and 8 h following the ifosfamide dose. On arm B, mesna was given in three equivalent doses 15 min before (i.v.) and 4 h (i.v.) and 8 h (p.o., double dose) following ifosfamide. On arm C, mesna was given i.v. in two equal doses given 15 min before and 4 h following. The incidence of urotoxicity was very low (lower than 15%) in the three arms, 0% in A, 1.36% in B and 2.70% in C. All three arms were equally efficient. Schedule C was considered superior to the others, since it was equally effective, simpler and more convenient.
authors.affiliation: Department of Medical Oncology, A. C. Camargo Hospital, São Paulo, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Katz
authors.forename: S
authors.initials: S
authors.lastname: Epelman
authors.forename: A
authors.initials: A
authors.lastname: Anelli
authors.forename: E F
authors.initials: EF
authors.lastname: Gorender
authors.forename: S M
authors.initials: SM
authors.lastname: Cruz
authors.forename: R M
authors.initials: RM
authors.lastname: Oliveira
authors.forename: L A
authors.initials: LA
authors.lastname: Marques
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D015080:Mesna / Q000008:administration & dosage*; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D015080:Mesna; D007069:Ifosfamide