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Introduction: For patients with refractory bone and soft tissue sarcoma (STS), treatment options have been limited. Ifosfamide is an alkylating agent with well-demonstrated efficacy against STS, and dose-dependent activity. The aim of this retrospective study was to evaluate the response rate, progression-free survival (PFS), progression-free rate (PFR), and median duration of response to high-dose ifosfamide (HDI) as at least second-line chemotherapy for patients with advanced bone sarcoma and STS. Patients and Methods: Thirty metastatic, unresectable sarcoma patients who were treated with HDI chemotherapy between May 1999 and November 2007 were included in the analysis. In total, 106 cycles (median 3 cycles; range 1–8 cycles) were administered. Twenty-one patients received treatment as second-line chemotherapy, and 9 patients as third-line treatment. HDI was given at a dose of 2 g/m2 over 3 h, and at a dose of 2 g/m2 per day; continuous infusion was administered on 6 consecutive days (2 g/m2/6 days) every 3 weeks. Results: After a median follow-up of 49 months (range 10–114), median PFS was 2.9 months (range 0.4–9.3) and median overall survival 8.7 months (range 0.4–57.8). The 3- and 6-month PFR were 47% (SE 9.1%) and 20% (SE 7.3%), respectively. Median response duration of HDI was 2.9 months (range 0.7–7.6). Of the 28 evaluable patients, 2 (7%) achieved complete response, 5 (18%) partial response, and 4 (14%) stable disease, and overall disease control was 39%. Two responders out of 7 (28.5%) and 4 patients out of 11 (36%) with controlled disease by HDI had a synovial sarcoma. Two patients were not evaluable because they were switched to another treatment due to ifosfamide-induced encephalopathy. Grade 3–4 neutropenia was seen in 13 (43%) patients, and treatment-related death was observed in one patient. Conclusion: HDI at a total dose of 14 g/m2 with mesna is still an active salvage regimen, particularly in patients with synovial sarcomas.

Objective: The aims of this study were to identify prognostic factors for overall survival (OS) in patients with small cell lung cancer (SCLC) and to construct a prognostic index on the basis of their expected OS. Long-term survivors were also given special attention. Methods: We retrospectively analyzed 295 patients diagnosed with SCLC from January 2002 to September 2007 at the Severance Hospital, Seoul, Republic of Korea. Patient history was reviewed regarding both clinical and tumor-related markers, and treatment-related factors were also evaluated. Results: There were 131 (44.4%) patients with limited disease (LD) and 164 (55.6%) with extensive disease (ED). Median follow-up lasted 9.4 months. Objective response to chemotherapy was 66.8%. The median survival time (MST) was 11.2 months in all patients, 20.4 months in LD patients, and 7.7 months in ED patients. The median progression-free survival was 9.4 months. Independent prognostic factors for overall survival (OS) were extent of disease, performance status, and CYFRA 21-1 level. We classified all patients into four groups based on the results of multivariate analysis using classification and regression tree analysis. Median survival times were 22.7, 13.7, 8.5, and 3.2 months, respectively. A total of 51 (17.3%) patients from the entire study population were evaluated for long-term survival, which was defined as survival >2 years. Their MST was 43.1 months, and extent of disease, performance status, and CYFRA 21-1 were independent prognostic factors for long-term survival. Conclusions: We confirmed the well-known prognosticators, disease extent and performance status, in our patients, but further identified CYFRA 21-1 as independent prognostic factor. A prognostic index was constructed to create four classifications of SCLC considering these variables.

Purpose: We investigated the efficacy and safety of weekly paclitaxel monotherapy in previously treated patients with advanced gastric cancer (AGC) and poor performance status (PS) according to the Eastern Cooperative Oncology Group (ECOG). Patients and Methods: Patients with evaluable disease who failed at least one previous chemotherapy and had a PS of 2–3, received paclitaxel 70 mg/m2 on days 1, 8 and 15 every 4 weeks. Results: The median overall survival (OS) was 5.5 months (95% confidence interval, CI, 3.3–7.8) and progression-free survival was 2.1 months (95% CI, 1.2–3.0). The overall response rate was 3.8% and the disease control rate was 25.0%. Treatment-related toxicities were tolerable. OS was 7.1 (95% CI, 5.4–9.5) and 3.7 months (95% CI, 2.1–5.3) for patients with PS-ECOG 2 and 3, respectively (p < 0.001). When evaluated according to the previous treatment, OS was 5.1 (95% CI, 3.3–7.0) and 6.5 months (95% CI, 3.8–9.3) for patients receiving two and three or more lines of treatment, respectively (p = 0.815). With multivariate analysis, PS was a significant factor for OS. Conclusion: Survival in patients treated with weekly paclitaxel monotherapy was comparable to other second- or third-line chemotherapies for AGC, with acceptable toxicities in previously treated patients with poor PS.