Chemotherapy (doxorubicin, cyclophosphamide, and vincristine) was given in a sequential fashion with radiation of the primary tumor and brain to 358 patients with small-cell lung carcinoma (extensive disease in 250, limited in 108). Complete regression of tumor was obtained in 14% of patients with extensive disease and 41% of patients with limited disease, and complete or partial response in 57% and 75%, respectively. Median survival was 26 weeks for patients with extensive disease and 52 weeks for those with limited disease. Response duration was longer for patients in complete remission; one third had disease-free survival greater than 1 year. Toxicity from the combined treatment modalities was no greater than expected from the components given separately: fatal in 3.9%, and life-threatening but reversible in 8.4% of patients. Whole-brain radiation was effective in preventing isolated relapse at that site. This therapy appears both feasible and effective, with acceptable risks and some benefit to most patients.

Fifty-six patients with squamous cell carcinoma of the head and neck were treated with the combination of vincristine, bleomycin, and methotrexate (VBM) on an every 2-week schedule. The overall CR + PR rate was 20%. Median response duration was 10 weeks. The toxicity during this trial was comparable to previously reported VBM regimens. The response rate was less than or no better than those previously reported for VBM or methotrexate alone. Therefore, this regimen offers nothing over methotrexate alone or other VBM regimens.