One hundred and thirteen patients with advanced lung cancer were treated with a four-drug combination chemotherapy consisting of cyclophosphamide, vincristine, methotrexate and procarbazine. Of those, ninety three (80 men and 13 women) patients were evaluated. Of 41 patients with small cell carcinoma, 10 (24%) achieved complete response (CR) and 18 (44%) achieved partial response (PR). The median duration of response was 5 months. The median survival time from initiation of chemotherapy was 11.3 months for patients with limited disease and 8 months for those with extensive disease. Responders lived significantly longer than non-responders; median survival time was 14 months for complete responders, 10.3 months for partial responders, and 6 months for non-responders. Of 52 patients with non-small cell carcinoma, 2 achieved CR and 15 achieved PR: The overall response rate was 33% ; with a response rate of 30% (8/27) for adenocarcinoma, 30% (6/20) for squamous cell carcinoma, and 60% (3/5) for large cell carcinoma. The median survival time was 13 months for patients with stage Ⅲ, and 8 months for those with stage Ⅳ. Responders with non-small cell carcinoma displayed a tendency toward longer survival periods; the median survival time was 8.3 months for responders compared with 6 months for non-responders.
Myelosuppressive toxicity remained within acceptable limits, with 8.8% incidence of leucocytepenia (1,000/cmm) and 6.7% incidence of thromobocytepenia (50,000/cmm) in repeated courses. These resuts indicate that this regimen is useful for the treatment of advanced lung cancer.