HIGH-DOSE IFOSFAMIDE PLUS ADRIAMYCIN IN THE TREATMENT OF ADULT ADVANCED SOFT-TISSUE SARCOMAS - IS IT FEASIBLE

Background: Adriamycin (ADM) and ifosfamide (IFO) are the two most act ive agents in the treatment of soft tissue sarcomas (STS) with a clear dose-response relationship. We evaluated the feasibility and toxicity of a high-dose IFO-plus-ADM combination. Patients and methods: Fourte en patients with advanced disease and nine patients in adjuvant settin g received IFO 12.5 g/m(2) in 120-hour continuous infusion with Mesna uroprotection and ADM 20 mg/m(2) on days 1-3 and G-CSF every three wee ks. Results: Twenty-three patients received 89 chemotherapy cycles (70 cycles at full dose). Seventeen patients received the planned treatme nt, and nine patients required dose reductions. We observed grade 3-4 neutropenia in 52 cycles (59%)/20 patients; grade 3-4 thrombocytopenia in 16 cycles (18%)/nine patients; grade 3-4 anaemia in 24 cycles (27% )/11 patients. Eight patients experienced febrile neutropenia and six patients required blood transfusions. Conclusions: While feasible, thi s regimen showed heavy toxicity. Nevertheless, 74% of the patients wer e able to complete the planned treatment. Adjustment of the schedule o f IFO continuous infusion to improve this combination is currently und er investigation.