Treatment of bronchogenic carcinoma with nitrogen mustard.

There have been numerous reports as to the clinical results obtained with the chloroethylamines (nitrogen mustards) In the treatment of Hodgkin’s disease, lymphosarcoma and leukemia.’-11’9 There has been a paucity of reported clinical trials in regard to the treatment of bronchogenic carcinoma with nitrogen mustard despite the fact that a few cases of carcinoma of the lung treated with nitrogen mustard have responded to therapy. Rhoads’2 states that cancer of the lung can be caused to regress temporarily in about 50 per cent of the instances and that these effects are transient and incomplete. The largest series of cases has been reported by Boyland, et. al.13 Their series included 41 histologically proved cases of bronchogenic carcinoma which were given methylbis(B chloroethyl) amine. These cases were unsuitable for other forms of therapy. Symptomatic relief and objective signs of improvement were noted in approximately one-half of them. Karnofsky has reported temporary symptomatic remissions in four patients with anaplastic carcinoma of the lung.’4 Skinner, et. al.’5 reported treating 25 cases of bronchogenlc carcinoma with nitrogen mustard and was of the opinion that clinical improvement was noted in about 70 per cent for periods ranging from six weeks up to six months, after which time the drug became ineffective. Ben-Asher9 published a report on 11 patients with carcinoma of the lung treated with nitrogen mustard, nine of whom did not respond to therapy. Wintrobe and Huguley’#{176} treated four cases of bronchogenic carcinoma; two of them had a fair response to therapy. Gellhorn and Jones state in their review, Chemotherapy of Malignant Diseases,” that some favorable therapeutic responses have been observed using nitrogen mustard In the treatment of anaplastic carcinoma of the lung, the exact significance of which must remain unsettled until further clinical trials can be undertaken.