Studies on treatment in lung cancer Part Ⅰ. Studies on chemotherapy in advanced lung cancer: Combination chemotherapy with FOBEM (5-fluorouracil, vincristine, bleomycin, cyclophosphamide and mitomycin C)

A regimen consisting of 5-fluorouracil, vincristine, bleomycin, cyclophosphamide and mitomycin C (FOBEM) was used for the treatment of 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 (28.6%) of 49 evaluated patients had significant tumor regression and included two patients with small cell carcinoma who shows complete regression. Histological classification indicated 17.6% of adenocarcinoma, 35.3% of squamous cell carcinoma and 57.0% of anaplastic carcinoma. And 12.5% of patients were diagnosed cytologically or clinically. Patients responding to FOBEM survived about two times longer after the initiation of chemotherapy than non-responders, and the survival was slightly longer in patients treated with FOBEM than in those administered one or two of these drugs. In aged patients pulmonary toxicity of bleomycin was the major dose limiting factor rather than the mild myelosuppressive toxicity, and the cumulative pulmonary toxicity necessitated the reduction of this drug. This FOBEM regimen warrants further investigation in the management of small cell and squamous cell carcinoma of the lung.