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Efficacy of Consolidation High-Dose Chemotherapy with Ifosfamide, Carboplatin and Etoposide (HD-ICE) Followed by Autologous Peripheral Blood Stem Cell Rescue in Chemosensitive Patients with Metastatic Soft Tissue Sarcomas.
- Source :
- Oncology; 2006, Vol. 71 Issue 1/2, p32-39, 8p, 4 Charts, 4 Graphs
- Publication Year :
- 2006
-
Abstract
- Background: Prognosis of patients with metastatic soft tissue sarcomas (MSTS) is poor even after response to doxorubicin-based chemotherapy. We report phase II data of high-dose chemotherapy and peripheral blood stem cell (PBSC) rescue in patients with MSTS responding to AI-G chemotherapy. Patients and Methods: From 1997 to 2002, 55 patients with MSTS were prospectively treated with 4 cycles of AI-G (doxorubicin 75 mg/m<superscript>2</superscript>, ifosfamide 6 g/m<superscript>2</superscript> with G-CSF support). Responders received 2 further cycles of AI-G with collection of PBSCs. High-dose chemotherapy consisted of ifosfamide 12 g/m<superscript>2</superscript>, carboplatin 1.2 g/m<superscript>2</superscript> and etoposide 1.2 g/m<superscript>2</superscript> (HD-ICE) followed by reinfusion of PBSCs. Results: Twenty-one of 55 patients (38%) were assessed as responders (3 complete response, 18 partial response). All but 2 patients refusing treatment received high-dose chemotherapy with PBSC rescue leading to grade IV hematologic toxicity without severe infections in all patients. No toxic death occurred. After a median follow-up time of 30 months, the median progression-free time was 12 months and survival time was 22 months for the entire group. By intent-to-treat analysis the probability of 5-year progression-free survival was significantly higher for patients allocated to HD-ICE compared to patients receiving second-line chemotherapy after failure of AI-G (14 vs. 3%; p = 0.003). The estimated 5-year overall survival between the 2 groups was different (27% vs. not reached) but did not reach significance (p = 0.08). Conclusion: HD-ICE is feasible and promising in patients with chemosensitive MSTS. A randomized phase III trial is warranted to further define the role of HD-ICE as consolidation treatment in these patients. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Subjects :
- DRUG therapy
CANCER prognosis
DOXORUBICIN
ETOPOSIDE
DRUG side effects
Subjects
Details
- Language :
- English
- ISSN :
- 00302414
- Volume :
- 71
- Issue :
- 1/2
- Database :
- Complementary Index
- Journal :
- Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 24635452
- Full Text :
- https://doi.org/10.1159/000100447