SOME PROBLEMS IN THE CHEMOTHERAPY OF SOLID TUMOURS

Chemotherapy of solid tumours is considered with respect to cell vulnerability, toxicity, tissue penetrability, tumour disruption and anatomical location. Chemotherapy to date has dealt primarily with the first two factors. Even when the cell is vulnerable to the agent used and host toxicity can be controlled, the other factors can lead to treatment failures. It is suggested that combinations of cytotoxic agents may be of more value than single agents. Timing and dosage are also considered. It is recommended that terminal cases and extremely toxic patients not be submitted to chemotherapy. In 78 patients with bronchogenic carcinoma, to whom nicotinic acid was given as a possible aid to tissue penetrability by nitrogen mustard, there was some indication that further similar studies might be of some value. Specific cases are summarized to illustrate the importance of various factors in the treatment of individual patients.