Results of using high-dose ifosfamide in disseminated soft tissue sarcomas in Kazakh Institute of Oncology and Radiology
Soft tissue sarcoma (STS) is one of the most adverse forms of tumors from the point of diagnostic and treatment due to its relatively rare occurrence and diversity of histological types. Surgery is the main treatment for STS. After local excision as an independent treatment, the frequency of local recurrence is 38.8 to 81.1% [14]. STS removal within its pseudocapsules results in tumor recurrence in about 90% cases; extensive local removal of tumor results in 40% recurrence; radical local tumor excision - in 10-15% recurrence [5-7]. Thus, surgical treatment for STS often results in local recurrence what has caused the search for new methods and treatment regimens for STS [3, 8]. The complex treatment of STS on the limbs has expanded the scope of organ-preserving surgery and significantly reduced the local recurrence rate. Chemotherapy based on doxorubicin and its analogs is now used to increase the 5-year survival of patients with primary and recurring STS. Adjuvant chemotherapy has increased 5-year survival of STS patients from 53 to 87% [9,10]. However, disseminated non-operable STS requires independent chemotherapy. Purpose of the study was to evaluate the effectiveness of high-dose ifosfamide chemotherapy in disseminated non-operable STS. Results: The treatment of disseminated non-oper-able STS with ifosfamide has resulted in a complete response in 9 (29%) cases, partial response - 15 (48.4%), progression - 4 (12.9%), and death - in 3 (9.7%) cases. Out of 31 STS patients, 3 had lung mts regression, 1 -main foci regression, 1 - lung mts stabilization, and in 2 cases death might have been caused by pancytopenia and acute kidney deficiency possibly caused by the collapse of the tumor with chemotherapy. Conclusion: High-dose ifosfamide treatment significantly expands the capacity of drug treatment of disseminated non-operable STS, especially rhabdo-sarcoma, synovial sarcoma, as well as malignant tumors of peripheral nerve shells and undifferentiated pleomorphic STS.