Chemotherapy for adenocarcinoma of the lung with 5‐fluorouracil, cyclophosphamide, and CCNU (FCC)

Thirty‐one adult patients with adenocarcinoma of the lung were treated with FCC chemotherapy consisting of 5‐fluorouracil (5‐FU), cyclophosphamide, and CCNU every 4 weeks. Thirteen patients received 5‐FU orally (POF) at the dose of 400 mg/m²/day in 4 divided daily doses for 5 days, whereas 18 patients received 5‐FU at the dose of 800 mg/m²/day for 5 days as a continuous intravenous infusion (CIF). All patients received cyclophosphamide and CCNU orally at doses of 200 mg/m²/day for 4 days and 40 mg/m²/day for 2 days, respectively. The overall response was 22%. Response was greater in patients treated with FCC‐CIF (4/14 vs. 1/9; p = 0.6), in patients with limited disease (4/13 vs. 1/10; p = 0.5), and in patients with good performance status, (4/16 vs. 1/7). The overall median survival duration was 9 months. The patients who achieved tumor regression survived significantly longer than patients who had disease stabilization (median, 21 vs. 9 months; p = 0.01), and the latter survived significantly longer than patients who had progressive disease (median, 9 vs. 2.5 months; p = 0.003). There was no significant difference in survival duration in the two FCC‐treated groups. Pretreatment extent of disease and performance status did not influence the survival of patients. However, the FCC‐CIF‐treated group contained a greater number of patients with extensive disease and poor performance status. Further investigations are indicated to evaluate the efficacy of 5‐fluorouracil administered by continuous intravenous infusion in combination with cyclophosphamide and CCNU in bronchogenic carcinoma.