Ifosfamide in the Adjuvant Therapy of Soft Tissue SarcomasFrustaci S. · De Paoli A. · Bidoli E. · La Mura N. · Berretta M. · Buonadonna A. · Boz G. · Gherlinzoni F.
Departments of aMedical Oncology, bRadiation Oncology and cEpidemiology and Biostatistics, Centro di Riferimento Oncologico di Aviano and dDivision of Orthopedics, General Hospital, Gorizia,Italy
Ifosfamide and anthracyclines are the only active agents in advanced soft tissue sarcomas. Doxorubicin was always used in sarcomas, whereas ifosfamide was reintroduced in the clinic after the discovery of mesna which prevents its typical dose-limiting toxicity: hemorrhagic cystitis. In the adjuvant setting, doxorubicin was used alone or in combination in the first-generation trials, whereas its parent compounds epirubicin and ifosfamide were employed in the second-generation adjuvant trials, which started in the early 90s. Other relevant aspects of the second-generation trials are the use of the hematopoietic growth factors and the increase of the dose intensity, the introduction of more restrictive selection criteria and the use of the two most active agents, ifosfamide and anthracyclines. Only the Italian cooperative trial has been concluded, and the results reported and updated. After a median follow-up of 89.6 months (range 56–119), the intention-to-treat analysis still reveals a difference in overall survival which, however, is not statistically significant. However, the 5-year overall survival estimate, which is a reasonable end point for the survival analysis of adjuvant treatment in soft tissue sarcomas, was 66.0 and 46.1% for the treatment and the control groups, respectively (p = 0.04).
Sergio Frustaci, MD
Department of Medical Oncology
Gastrointestinal Tumors and Sarcoma Unit
Via Pedemontana Occ. 13, IT–33184 Aviano/PN (Italy)
Tel. +39 0434 659253, Fax +39 0434 659503, E-Mail email@example.com
The Italian Sarcoma Group and the participating centers include: Istituto Ortopedico Rizzoli, Bologna; Centro di Riferimento Oncologico di Aviano (Pordenone); Divisione di Radioterapia, Università di Firenze; Istituto di Radioterapia, Università di Bologna; Unità Operativa di Oncologia Medica, Ospedale di Gradenigo; Torino, Unità Operativa di Oncologia Medica, Istituto Europeo di Oncologia, Milano; Unità Operativa di Oncologia Medica B, Istituto Pascale, Napoli; Unità Operativa di Chirurgia Muscolo-scheletrica, Istituto Nazionale Tumori, Milano; Unità Operativa di Oncologia Ortopedica, Ospedale Civile, Brescia; Unità Operativa di Oncologia Medica, Istituto S. Raffaele, Milano; Unità Operativa di Oncologia Medica, Ospedale Civile, Reggio Emilia; Medical Oncology Division, Ljubliana, Slovenia.
Number of Print Pages : 5
Number of Figures : 4, Number of Tables : 1, Number of References : 16
Oncology (International Journal of Cancer Research and Treatment)
Founded 1948 as ‘Oncologia’ by H.R. Schinz; Continued by V. Richards (1967–1975), H. Wrba (1976–1992), P.P. Carbone (1993–2002)
Vol. 65, No. Suppl. 2, Year 2003 (Cover Date: Released November 2003)
Journal Editor: D.L. Trump, Buffalo, N.Y.
ISSN: 0030–2414 (print), 1423–0232 (Online)
For additional information: http://www.karger.com/onc