[A combination chemotherapy with adriamycin, cyclophosphamide and DTIC (ACD) for advanced adult soft part sarcoma]

Eighteen patients with advanced adult soft part sarcoma were treated with a combination chemotherapy (ACD) consisting of adriamycin 40 mg/m2 iv day 1, cyclophosphamide 500 mg/m2 iv day 1, and DTIC 200 mg/m2 iv days 1 to 5. The regimen was repeated in 3-weeks intervals. Of 16 patients with measurable metastatic diseases, there were one complete response, 4 partial responses, 7 no changes and 4 progressive diseases. The response rate (CR + PR) was 31% (5/16). A median duration of responses was 7 weeks ranging 6 to 106 + weeks. A median survival time from initiation of the chemotherapy was 42 weeks in responders, and 36 weeks in non-responders, respectively. Patients with no prior chemotherapy had a 71% (5/7) response rate while none responded in 9 patients who had prior chemotherapy; furthermore, metastatic lesions in soft tissue were well responded. Leukopenia less than 4,000/cmm occurred in 16/18 (89%) and the median nadir was 2,500/cmm (800-3900). Thrombocytopenia less than 10 X 10(4)/cmm occurred in 2/18 (11%) and the median nadir was 13.4 X 10(4)/cmm (7.5-20.1 X 10(4). Alopecia and gastrointestinal toxicity were moderate to severe but clinically manageable. The result indicated that ACD combination is a useful regimen in remission induction for advanced adult soft part sarcoma.