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      Consolidation with high-dose chemotherapy and stem cell support for responding patients with metastatic soft tissue sarcomas: prospective, single-institutional phase II study.

      Bone Marrow Transplantation

      Survival Rate, Antineoplastic Combined Chemotherapy Protocols, therapy, pathology, mortality, drug therapy, Sarcoma, Neoplasm Metastasis, administration & dosage, Ifosfamide, Humans, methods, Hematopoietic Stem Cell Transplantation, Doxorubicin, Dose-Response Relationship, Drug

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          Abstract

          Prognosis of patients with metastatic soft tissue sarcoma remains poor. Whether high-dose chemotherapy with stem cell support improves the long-term outcome for these patients is debatable. We present a prospective, single-institutional phase II study that enrolled 34 soft tissue sarcoma patients with advanced and/or metastatic disease. After four courses of chemotherapy consisting of doxorubicin and ifosfamide, responding patients in at least partial response (PR) were treated with high-dose chemotherapy (n=9); all other patients continued chemotherapy for two more cycles. After standard chemotherapy, PR (n=10), stable disease (SD, n=6) and progressive disease (PD, n=14) were attained for the evaluable patients. Twenty-nine patients died and five are alive with the disease. Median PFS was 11.6 months (range 8-15) for patients treated with high-dose chemotherapy (n=9) vs 5.6 months (range 0-19) for patients treated with standard chemotherapy. Median OS was 23.7 months (range 12-34) vs 10.8 months (range 0-39), respectively. The subgroup of patients treated with high-dose chemotherapy gained significant survival benefit. Nevertheless, high-dose chemotherapy as a possible consolidation strategy remains highly investigational.

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          Journal
          10.1038/bmt.2009.333
          19935728

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