title: Mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) chemotherapy for gynecological sarcomas.
abstract: This report summarizes our experience with the combination of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) for patients with gynecological sarcomas. We reviewed the records of all patients who had received the MAID regimen for a gynecological sarcoma between 1993 and 2000. The MAID regimen was administered intravenously every 4 weeks in the hospital as follows: (1) mesna 1500 mg/m2/day x 4 days; (2) doxorubicin 15 mg/m2/day x 3 days; (3) ifosfamide 1500 mg/m2/day x 3 days; (4) dacarbazine 250 mg/m2/day x 3 days. The results of treatment with MAID were disappointing. Overall, the response rate was 9% with one complete response and one partial response (both in patients with uterine leiomyosarcoma). We did not observe any responses among the patients with carcinosarcomas of either ovarian or uterine origin. The median progression-free interval and survival were 11 months and 29 months, respectively. This regimen was associated with substantial toxicity (including a death from neutropenic sepsis) as well as high cost and inconvenience due to the requirement for inpatient administration. Although our study contains a limited number of patients with a variety of gynecological sarcomas, our review has led us to discontinue using MAID. It remains to be established if any combination chemotherapy regimen is better than single agent treatment.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Medicine, State University of New York at Stony Brook, Stony Brook, New York, USA. mlpearl@notes.cc.sunysb.edu
authors.forename: M L
authors.initials: ML
authors.lastname: Pearl
authors.forename: M
authors.initials: M
authors.lastname: Inagami
authors.forename: D L
authors.initials: DL
authors.lastname: McCauley
authors.forename: F A
authors.initials: FA
authors.lastname: Valea
authors.forename: E
authors.initials: E
authors.lastname: Chalas
authors.forename: M
authors.initials: M
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002296:Carcinosarcoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D003606:Dacarbazine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007890:Leiomyosarcoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008499:Medical Records; D015080:Mesna / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D009518:New York; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D014846:Vulvar Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology
chemical_list: D003606:Dacarbazine; D004317:Doxorubicin; D015080:Mesna; D007069:Ifosfamide