Chemotherapy for Lung Cancer

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To the editor: In their recent article Hansen and associates (1) state that the superiority of their four-drug therapy (CCNU, cyclophosphamide, methotrexate, vincristine) over the three-drug regimen (CCNU, cyclophosphamide, methotrexate) is “easily accepted as related to the use of vincristine.” One aspect of their data leads us to question this conclusion and provokes several thoughts on their study.

Patients with the longest survival (median, 256 days) were those responding to the four-drug regimen, a result that is easily accepted because these patients had the longest remissions (median, 186 days). It was therefore surprising to find that the survival of those

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