(P 153) IFOSFAMIDE/ETOPOSIDE/CARBOPLATIN REGIMEN AS A POST DOXORUBICIN TREATMENT IN METASTATIC OR RECURRENT SOFT TISSUE SARCOMA

Objective: Post doxorubicin treatment is a common practice in metastatic or recurrent soft tissue sarcoma. Gemcitabine/Docetaxel (GD) is often used in 2nd line palliative chemotherapy because high-dose ifosfamide regimen induces severe hematologic toxicities and treatment-related death. However, the effect of ifosfamide is non-inferior to doxorubicin. Therefore, there may be cases where ifosfamide treatment is clinically appropriate for post doxorubicin treatment in in metastatic or recurrent soft tissue sarcoma. This study aimed to retrospectively compare the treatment outcomes between GD and ifosfamide/etoposide/platinum (ICE).

Methods: This study was conducted in metastatic or recurrent soft tissue sarcoma patients after doxorubicin-based chemotherapy. All the patients were treated with GD or ICE at Seoul St. Mary’s hospital and St. Vincent’s hospital. Medical records including clinical information and treatment outcomes were reviewed.

Results: This study included 61 patients. Synovial sarcoma (12 patients), Leiomyosarcoma (9 patients), and liposarcoma (10 patients) are most common. Thirty-six patients were treated with GD and 25 patients were ICE. The patients treated with ICE had trend more fit than GD group by ECOG-PS. The median overall survivals by the log rank test were similar between GD (10 months) and ICE group (15 months) (p = 0.062). The median progression free survival of GD group was 2 months and ICE group was 4 months (p= 0.688). There was not the significant difference of objective response between GD (13.9%) and ICE (16%) group. Although the most patients of ICE group were treated with long-acting G-CSF, ICE group had more grade 3 or 4 neutropenia and thrombocytopenia than GD group. However, Hematologic toxicities were manageable with long-acting G-CS and there was not the treatment related death in ICE group.

Conclusion: Ifosfamide based regimen can be an alternative option in post doxorubicin treatment for metastatic or recurrent soft tissue sarcoma. Long-acting G-CSF is needed for the manages of hematologic toxicities.