The battle of Hue was a more recent case, but it was impossible to to avoid destroying the center city. I'm aware of a couple of squadrons who, almost single handedly, made rubble of the center city because the NVA was already entrenched in virtually every building that was more than one floor. Even with today's house-to-house methodology and doctrine, if the same situation arose, I think the result would be similar.
In Hue a Thermobaric ole BLU-118/B could be used and save all the room to room as well as save most of the structure...to bad it was not available!