Safety of Reduced Infusion Volume and Shortened Antiemetic Administration Period in Ifosfamide–Doxorubicin Combination Therapy for Malignant Soft Tissue Tumors

Combination therapy with ifosfamide and doxorubicin (AI) is a standard treatment for malignant soft tissue tumors. However, we have encountered a high incidence of edema in patients with AI receiving the standard supportive care regimen at our hospital. Based on a report indicating that dexamethasone has a noninferior antiemetic effect in chemotherapy regimens even with a shorter duration of administration, the total infusion volume was reduced from 3,000 to 2,000 mL, and the administration period of dexamethasone and granisetron was shortened from 4 to 3 days after discussion with physicians. We conducted a retrospective descriptive analysis of patients who received the first course of AI for malignant soft tissue tumors in our institution between May 1, 2014, and March 31, 2020 to examine the impact of changing the regimen. There were 17 patients in the 3,000-mL group and 18 patients in the 2,000-mL group. The incidence of edema decreased from 82％ in the 3,000-mL group to 44％ in the 2,000-mL group. No decrease in creatinine clearance was observed after the treatment in either group, and no cases of hemorrhagic cystitis developed. The complete response rates were 65％ and 50％ (acute period) and 76％ and 44％ (delayed period) for the 3,000 mL and 2,000 mL groups, respectively. Thus, AI chemotherapy could be administered with reduced edema, without affecting renal function, by reducing the amount of fluid administered and the number of days of antiemetic drug administration. However, delayed vomiting remains an issue that needs to be addressed.