A treatment schedule combining 5 fluorouracil, vincristine, bleomycin, cyclo phosphamide and mitomycin C (FOBEM) was administered to advanced lung cancer patients. 5 Fluorouracil (250mg) was administered every other day. Vincristine (1mg), bleomycin (15mg), cyclophosphamide (400mg) and mitomycin C (4mg) were each administered once a week for six consecutive weeks. Fourteen of 49 (28.6%) evaluated patients had significant tumor regression. Included among the 14 were two patients with small cell carcinoma with complete regression.
Histological classification indicated: 17.6%, adenocarcinoma; 35.3%, squamous cell carcinoma; and 57.0%, anaplastic carcinoma; 12.5% of patients were diagnosed cytologically or clinically. Patients responding to FOBEM therapy survived about two times longer after initiation of chemotherapy than non-responders, and the survival of patients treated with FOBEM therapy was slightly longer than those administered single drugs or a two drug combination. In aged patients pulmonary impairment with bleomycin was the major dose limiting factor instead of mild myelosuppressive toxicity, and the cumulative pulmonary toxicity necessitated the reduction of this drug. Combination chemotherapy with 5 fluorouracil, vincristine, bleomycin, cyclophosphamide and mitomycin C warrants further investigation in the management of small cell and squamous cell carcinoma of the lung.
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