BACKGROUND: Good local control of high-grade non-small round cell soft tissue 
sarcomas (NSRCSTSs) has been achieved with significant advances in surgical 
techniques and radiotherapy. However, the role of chemotherapy remains 
controversial. Our aim was to investigate the efficacy, feasibility and adverse 
effects of neoadjuvant and adjuvant chemotherapy with modified mesna, 
adriamycin, ifosfamide and dacarbazine (MAID) regimen for NSRCSTSs.
METHODS: We conducted a retrospective review of 40 consecutive patients (29 men, 
11 women; median age 47 years) with high-grade NSRCSTSs treated in two referral 
centers between 2004 and 2009 (median follow-up 38.5 months). Patients with 
distant or nodal metastases at diagnosis were excluded. The regimen consisted of 
ifosfamide 2,500 mg/m(2)/6 h (days 1-3), mesna 2,500 mg/m(2)/6 h (days 1-3), 
tetrahydropyranyl adriamycin 20 mg/m(2)/0.5 h (days 1-3), and dacarbazine 300 
mg/m(2)/1 h (days 1-3).
RESULTS: Among the 26 evaluable patients, there were 8 with a partial response, 
15 with stable disease, and 3 with progressive disease. Two- and 5-year overall 
survival rates were 92 and 86%, respectively, and corresponding disease-free 
survival rates were 80 and 77%. All relapses were metastases without local 
recurrence. Grade 3-4 neutropenia, anemia and thrombocytopenia were observed in 
38, 18, and 21 patients, respectively. No serious infectious complications 
occurred due to the administration of granulocyte colony-stimulating factor and 
prophylactic antibiotics. No other life-threatening serious adverse events were 
observed.
CONCLUSION: The modified MAID regimen achieved a better outcome with less 
serious adverse events than previously reported and is a potential option in the 
management of NSRCSTSs. Further evaluation with long-term follow-up is required.