Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

Doxorubicin and ifosfamide in soft tissue sarcoma

First line in advanced sarcoma; mesna, G-CSF and encephalopathy prevention

Updated: 28 October 20261 min read1 reference

Summary for doctors

  • Advanced soft tissue sarcoma, first line; when tumour shrinkage is the goal [1].
  • Higher response and longer progression-free survival than doxorubicin alone, but no significant difference in overall survival [1].
  • High toxicity: only in fit patients.

Dose and schedule

Doxorubicin + ifosfamide

Advanced soft tissue sarcoma

Advanced soft tissue sarcoma

DrugDoseRouteSchedule
Doxorubicin75 mg/m²IVDay 1 (or divided over 3 days)
Ifosfamide2.5 g/m² a day (10 g/m² in total)IVDays 1 to 4
MesnaEqual to or more than the ifosfamide doseIV (and oral)Days 1 to 4
Cycle length
Every 21 days with G-CSF
Duration
6 cycles

As in EORTC 62012 [1].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • Primary G-CSF prophylaxis; highly emetogenic antiemetics; hydration.
  • Mesna to prevent haemorrhagic cystitis.

Monitoring and dose adjustment

  • Ifosfamide encephalopathy (confusion, drowsiness, hallucinations): stop; methylene blue in severe cases.
  • Creatinine, phosphate and potassium (tubulopathy); baseline echocardiogram; cumulative doxorubicin dose.

Main evidence

Show detailsHide

EORTC 62012: response 26% vs 14% and median progression-free survival 7.4 vs 4.6 months; median overall survival 14.3 vs 12.8 months (no significant difference) [1].

References

1 reference
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Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trialJudson I, Verweij J, Gelderblom H, et al · Lancet Oncol · 2014;15:415-23
    DOIPubMed Back to text: 1 2 3 4

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/doxorubicin-ifosfamide-sarcoma/

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