The benefits of polychemotherapy in advanced (Stage 111) non-small-cell bronchogenic carcinoma remain uncertain. In attempt to answer the important question whether treatment improves well-being and survival in these patients, we did a prospective, randomized, single-blind study to compare polychemotherapy to a placebo. Thirty-nine consecutive patients were enrolled. Twenty received a drug combination consisting of: methotrexate, doxorubicine hydrochloride (Adriamycin), cyclophosphamide, and lomustine (CCNU) (MACC). The other group (19 subjects) received a placebo physically comparable to MACC. The two groups were initially comparable in terms of age, sex, clinical status, and tumor burden. In the treated group, seven patients had a radiologic response (more than 50% reduction in the tumor size), and the tumor stabilized in an additional five subjects. There were no responders in the placebo group. Median survival was 30.5 weeks for the MACC group compared to 8.5 weeks in the placebo group (P < 0.0005, Gehan-Wilcoxon). We conclude that polychemotherapy (in this case MACC) significantly benefits patients with advanced non-small-cell lung cancer.
Cancer 50845-849, 1982.
ECENT STUDIES have clearly demonstrated that R bronchogenic small-cell carcinoma respond favorably to chemotherapy.' Although the best combination of drugs needs to be defined, it is well accepted that patients benefit from such treatments.* As for the more frequent non-small-cell bronchogenic carcinomas, the usefulness of chemotherapy, is less obvious and accepted. The latest edition of Harrison's Principles of Medicine mentions that chemotherapy, in this type of cancer, is disco~raging.~ It is common practice to provide only palliative radiotherapy for these patients. However, some recent studies suggest at least partial response to chemotherapy, especially for adenocarcino ma^.^-^ Whether or not this prolongs survival is less obvious. Prospective studies failed to demonstrate prolonged survival and well-being after chemotherapy as compared to a pla~ebo.'.~ In an attempt to answer the important question whether patients with non-small-cell advanced (Stage 111) lung carcinoma would benefit from chemotherapy