High-dose-intensity combination chemotherapy for advanced sarcomas: a pilot study

A new polychemotherapy schedule involving high dose intensity and shortened intervals has been developed for patients with advanced sarcomas. Mesna at 2500 mg/m2 for 3 days, epidoxorubicin at 60 mg/m2 on day 1, ifosfamide at 2500 mg/m2 for 3 days, and dacarbazine at 450 mg/m2 for 2 days were given every 2 weeks to a consecutive series of 20 patients. All patients received granulocyte colony-stimulating factor (G-CSF; Filgrastim) subcutaneously at 300 microg from day 5 to day 12 of each cycle. The treatment was feasible and toxicity was acceptable, with grade IV myelotoxicity being observed only in one case. In all, 6 of 14 evaluable patients had an objective response; the median survival was 12 months. Toxicity was milder than that observed for the classic combination MAID, and the planned dose intensity was maintained in the majority of cases.