Results of novel strategies for treatment of Wilms' tumor
OBJECTIVE: To evaluate treatment outcomes in Wilms' tumor (WT). MATERIALS AND METHODS: We studied 53 children with median age of 2 years with WT, stages I-19, II-14, III-12, IV-6 and V-2. Treatment consisted of surgical excision plus adjuvant (40 children) or neoadjuvant and adjuvant chemothera...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2007-04-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000200011 |
| _version_ | 1817969509685788672 |
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| author | Silvio Tucci Jr Adauto J. Cologna Haylton J. Suaid Elvis T. Valera Luis F. Tirapelli Edson L. Paschoalin Antonio C. Martins |
| author_facet | Silvio Tucci Jr Adauto J. Cologna Haylton J. Suaid Elvis T. Valera Luis F. Tirapelli Edson L. Paschoalin Antonio C. Martins |
| author_sort | Silvio Tucci Jr |
| collection | DOAJ |
| description | OBJECTIVE: To evaluate treatment outcomes in Wilms' tumor (WT). MATERIALS AND METHODS: We studied 53 children with median age of 2 years with WT, stages I-19, II-14, III-12, IV-6 and V-2. Treatment consisted of surgical excision plus adjuvant (40 children) or neoadjuvant and adjuvant chemotherapy (unresectable tumor, n = 8, or caval tumor extension, n = 5). Chemotherapy and radiotherapy followed protocols of Brazilian Wilms' Tumor Study Group excepting 16 cases with stage I disease that received a short duration postoperative treatment with vincristine (VCR - 11 doses) and dactinomycin (AMD - 4 doses). Relapsed WT was treated with multiagent regimens including cisplatin/carboplatin, cyclophosphamide, ifosfamide and etoposide. One patient with resistant relapsed WT was treated by high-dose conditioning chemotherapy with stem cell rescue. RESULTS: Overall and disease-free survival rates at 5 years were respectively 88.2 ± 5.0% and 76.7 ± 6.6%. Short duration therapy for stage I tumor showed a disease-free survival rate of 100% in a median time of 101 months (range 14 to 248 months). Overall and disease-free survival of 10 patients with recurrent WT at 5 years was 42.8%. The child treated with high-dose chemotherapy plus stem cell transplant is alive without evidence of disease 84 months from relapse. CONCLUSION: The postoperative chemotherapy in stage I disease can be reduced without compromising the cure rate. The treatment of unfavorable stage III and IV disease or relapsed tumor remains a challenge. |
| first_indexed | 2024-04-13T20:21:58Z |
| format | Article |
| id | doaj.art-85e5c15cb0eb41f58e6dddc85c1a1198 |
| institution | Directory Open Access Journal |
| issn | 1677-5538 1677-6119 |
| language | English |
| last_indexed | 2024-04-13T20:21:58Z |
| publishDate | 2007-04-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-85e5c15cb0eb41f58e6dddc85c1a11982022-12-22T02:31:30ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192007-04-0133219520310.1590/S1677-55382007000200011Results of novel strategies for treatment of Wilms' tumorSilvio Tucci JrAdauto J. ColognaHaylton J. SuaidElvis T. ValeraLuis F. TirapelliEdson L. PaschoalinAntonio C. MartinsOBJECTIVE: To evaluate treatment outcomes in Wilms' tumor (WT). MATERIALS AND METHODS: We studied 53 children with median age of 2 years with WT, stages I-19, II-14, III-12, IV-6 and V-2. Treatment consisted of surgical excision plus adjuvant (40 children) or neoadjuvant and adjuvant chemotherapy (unresectable tumor, n = 8, or caval tumor extension, n = 5). Chemotherapy and radiotherapy followed protocols of Brazilian Wilms' Tumor Study Group excepting 16 cases with stage I disease that received a short duration postoperative treatment with vincristine (VCR - 11 doses) and dactinomycin (AMD - 4 doses). Relapsed WT was treated with multiagent regimens including cisplatin/carboplatin, cyclophosphamide, ifosfamide and etoposide. One patient with resistant relapsed WT was treated by high-dose conditioning chemotherapy with stem cell rescue. RESULTS: Overall and disease-free survival rates at 5 years were respectively 88.2 ± 5.0% and 76.7 ± 6.6%. Short duration therapy for stage I tumor showed a disease-free survival rate of 100% in a median time of 101 months (range 14 to 248 months). Overall and disease-free survival of 10 patients with recurrent WT at 5 years was 42.8%. The child treated with high-dose chemotherapy plus stem cell transplant is alive without evidence of disease 84 months from relapse. CONCLUSION: The postoperative chemotherapy in stage I disease can be reduced without compromising the cure rate. The treatment of unfavorable stage III and IV disease or relapsed tumor remains a challenge.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000200011Wilms' tumorsurgerychemotherapyrelapse |
| spellingShingle | Silvio Tucci Jr Adauto J. Cologna Haylton J. Suaid Elvis T. Valera Luis F. Tirapelli Edson L. Paschoalin Antonio C. Martins Results of novel strategies for treatment of Wilms' tumor International Brazilian Journal of Urology Wilms' tumor surgery chemotherapy relapse |
| title | Results of novel strategies for treatment of Wilms' tumor |
| title_full | Results of novel strategies for treatment of Wilms' tumor |
| title_fullStr | Results of novel strategies for treatment of Wilms' tumor |
| title_full_unstemmed | Results of novel strategies for treatment of Wilms' tumor |
| title_short | Results of novel strategies for treatment of Wilms' tumor |
| title_sort | results of novel strategies for treatment of wilms tumor |
| topic | Wilms' tumor surgery chemotherapy relapse |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000200011 |
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