Phase II evaluation of doxorubicin, ifosfamide, and dacarbazine plus amphotericin B in the treatment of metastatic soft tissue sarcomas. A pilot study
González-Manzano R., Vieitez J.M., Tangco E., Fernández de Álava E., Herranz P, Garcia-Foncillas J.
Department of Oncology and Pathology, Clinica Univesitaria de Navarra, Pamplona, Spain.
Revisão:American Journal of Clinical Oncology
Data: 1/Ago/1993Oncologia Médica
Amphotericin B enhances the cytotoxicity of certain antineoplastic agents in vitro and in vivo. A phase II study was designed to evaluate whether this effect can be produced in the treatment of metastatic soft-tissue sarcomas (STS).
The program AIDAB consisted of ADM 50 mg/m2 i.v. bolus at day 1; ifosfamide (IFX) 1.5 g/m2 in 1 hour i.v. infusion/day x 3 days; mesna 300 mg/m2 i.v. bolus before and 4 and 8 hours after IFX; dacarbazine (DTIC) 400 mg/m2 i.v. in 6 hours infusion/day x 3 days; and amphotericin B 25 mg/m2 i.v. in 6 hours infusion/day x 3 days; repeated every 4 weeks. There were 25 patients evaluable for response and toxicity, 22 with no previous chemotherapy. The median age was 44, (range: 16-64); 14 males, 11 females with a Karnofsky range of 40 to 90%. The response rate was 48% (4% complete response and 44% partial response). The median duration of response was 6.6 months. Of these 25 patients, 17 (68%) have died; the median survival was 12 months (range: 3-51 months). A total of 175 cycles were given to the 25 patients, with a mean of 7 cycles per patient.
Toxicities encountered were leukopenia and/or thrombocytopenia, grade IV (WHO), in 9 patients (36%); fever and chills during amphotericin B infusion in 40%; vomiting, grade III (WHO), in 56%; mild mucositis in 12%, and a symptomatic decrease in cardiac ejection fraction in one patient. There was one toxic death due to severe thrombocytopenia.
We can conclude that AIDAB is effective in the treatment of metastatic soft-tissue sarcoma. The addition of amphotericin B did not improve the response rate or survival above what is expected from chemotherapy alone.
CITAÇÃO DO ARTIGO Am J Clin Oncol. 1993 Aug;16(4):332-7
A Clínica é o hospital privado com maiores recursos tecnológicos de Espanha, tudo num único centro.
Os profissionais da Clínica realizam um trabalho contínuo de investigação e formação, sempre em benefício do paciente.
Conheça porque é que somos diferentes em relação a outros centros sanitários. Qualidade, rapidez, comodidade e resultados.