Combination chemotherapy and whole lung irradiation for pulmonary metastases from sarcomas and germinal cell tumors of the testis

Seven patients with sarcomas and seven with testicular carcinomas with lung metastases were treated with a multiple drug regimen of actinomycin D, cyclophosphamide, and vincristine (plus mithramycin in testicular primaries) given in a 2‐week cycle followed by a 2‐week rest period. The patients received concurrent whole lung irradiation to 1500 rads in 10 fractions. The complete response rate was 50%. Eight patients survived more than 1 year after beginning the combination therapy. Five patients have survived from 12 to 31 months, and three have been continuously free of disease. Hematologic and gastrointestinal toxicity was acceptable. Two patients developed clinical radiation pneumonitis. The results of this pilot study suggest that multiple drug therapy combined with radiation therapy to known sites of disease and to both entire lungs may offer longer complete remissions in these patients than would result from chemotherapy or radiation therapy alone.