title: Alternating sequential chemotherapy with high-dose ifosfamide and doxorubicin/cyclophosphamide for adult non-small round cell soft tissue sarcomas.
abstract: Doxorubicin and ifosfamide are the two most active agents used to treat soft tissue sarcomas. However, because of their overlapping side effects, concurrent administration to achieve optimal doses of each agent is difficult. We therefore conducted a Phase II trial to investigate the efficacy and feasibility of a novel alternating sequential chemotherapy regimen consisting of high dose ifosfamide and doxorubicin/cyclophosphamide in advanced adult non-small round cell soft tissue sarcomas. Adult patients with non-small round cell soft tissue sarcomas were enrolled. The treatment consisted of four sequential courses of chemotherapy that was planned for every 3 weeks. Cycles 1 and 3 consisted of ifosfamide (14 g/m(2)), and cycles 2 and 4 consisted of doxorubicin (60 mg/m(2)) and cyclophosphamide (1200 mg/m(2)). Forty-two patients (median age 47 years) were enrolled. Of the 36 assessable patients, 1 complete response and 16 partial responses were observed, for a response rate of 47.2%. Responses were observed in 57% of patients who had received no previous chemotherapy and 13% of those who had previously undergone chemotherapy. Grade 3-4 neutropenia was observed during 70% of all cycles. Sequential administration of high-dose ifosfamide and doxorubicin/cyclophosphamide has promising activity with manageable side effects in patients with advanced adult non-small round cell soft tissue sarcomas.
authors.affiliation: Division of Orthopaedic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.forename: Toru
authors.initials: T
authors.lastname: Umeda
authors.forename: Takuro
authors.initials: T
authors.lastname: Wada
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ihara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Isu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Abe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishii
authors.forename: Hideshi
authors.initials: H
authors.lastname: Sugiura
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Araki
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
authors.forename: Hiroo
authors.initials: H
authors.lastname: Yabe
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Beppu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000188:drug therapy*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D007069:Ifosfamide