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Sarcoma
Volume 2013 (2013), Article ID 868973, 6 pages
http://dx.doi.org/10.1155/2013/868973
Clinical Study

Clinical Activity and Tolerability of a 14-Day Infusional Ifosfamide Schedule in Soft-Tissue Sarcoma

1Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK
2Department of Histopathology, The Royal Marsden Hospital, Fulham Road , London SW3 6JJ, UK
3Department of Statistics, The Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK
4Department of Radiodiagnostics, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK
5Spanish National Cancer Research Centre (CNIO), Clinical Research Programme, 3 Melchor Fernandez Almagro, 28029 Madrid, Spain
6Department of Pharmacy, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK

Received 24 September 2013; Revised 16 October 2013; Accepted 17 October 2013

Academic Editor: Shreyaskumar Patel

Copyright © 2013 Juan Martin-Liberal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Soft-tissue sarcomas (STS) are a heterogeneous group of diseases with lack of effective treatments in most cases. Previous data suggest that continuous infusional ifosfamide regimens might improve cytotoxicity and tolerability compared to standard schedules. Methods. We retrospectively report the outcome of 35 patients affected by STS treated with a 14-day infusional ifosfamide regimen (1000 mg/m2/day) in our institution. Predictive factors for toxicity were also explored. Results. Median age was 53 years. There were 16 males and 19 females. Classification by histology was dedifferentiated liposarcoma (DDLPS): 22 (62.8%), synovial sarcoma: 7 (20%), myxoid/round-cell liposarcoma: 3 (8.5%), and others: 3 (8.5%). Overall, 7 patients (20%) achieved partial response (PR) and 10 patients (29%) achieved stable disease (SD). DDLPS showed special sensitivity: 5 patients (22.7%) had PR, 7 patients (31.8%) had SD, and disease control rate was 54.5%. Median progression-free survival and overall survival were 4.2 and 11.2 months, respectively. The most common toxicities were fatigue, nausea, and vomiting (all grades: 85.7%, 83%, and 54.3%, resp.). Neither hypoalbuminaemia nor gender was found to predict toxicity, although encephalopathy predominantly affected females. Conclusion. Ifosfamide administered as a 14-day continuous infusion is a safe regimen in STS with notable activity in DDLPS.