PMID- 1656009
OWN - NLM
STAT- MEDLINE
DCOM- 19911113
LR  - 20190710
IS  - 0022-3468 (Print)
IS  - 0022-3468 (Linking)
VI  - 26
IP  - 8
DP  - 1991 Aug
TI  - Preoperative chemotherapy for children with Wilms' tumor.
PG  - 949-53; discussion 953-6
AB  - Five years ago, the use of preoperative chemotherapy for Wilms' tumor was adopted 
      at this institution. Thirty children ranging in age from 5 months to 9 years had 
      histologically confirmed Wilms' tumor (needle biopsy, n = 26; open biopsy, n = 
      4). Stage was determined by chest and abdominal computed tomography (CT) scan. 
      Bilateral tumors were present in 6 children. All children received actinomycin D 
      and vincristine from 3 weeks to 6 months before surgery. Seven children with 
      bilateral tumors or stage IV disease also received adriamycin. CT-measured tumor 
      masses shrunk in most cases. Subsequently, nephrectomy was performed in 23 
      patients and partial nephrectomy in 4, 2 of whom had bilateral disease. In 2 
      patients, residual bilateral well-differentiated epithelial tumor was not 
      surgically resected. One child died before surgery. Reevaluation at delayed total 
      or partial nephrectomy resulted in a downstaging of disease in 12 (41%). Further 
      chemotherapy and radiation was based on the surgical stage. Postoperative 
      chemotherapy (4 months to 2 years) was administered to all patients. The chest 
      and/or abdomen were radiated in 12. Four patients (13%) died, 1 of radiation 
      pneumonitis and 3 of the disease progression (2 with unfavorable histology, 1 of 
      whom had bilateral disease). Two of 4 with unfavorable histology and 4 of 6 with 
      stage IV disease have survived. It is concluded that this preoperative 
      chemotherapy protocol is as effective as the National Wilms' Tumor Study (NWTS) 
      protocol. The treated tumor is smaller, less friable, and easier to remove. 
      Furthermore, because of downstaging, less radiation is necessary for cure.
FAU - Greenberg, M
AU  - Greenberg M
AD  - Division of Haematology/Oncology, Hospital For Sick Children, Toronto, Ontario, 
      Canada.
FAU - Burnweit, C
AU  - Burnweit C
FAU - Filler, R
AU  - Filler R
FAU - Weitzman, S
AU  - Weitzman S
FAU - Sohl, H
AU  - Sohl H
FAU - Chan, H
AU  - Chan H
FAU - Jenkin, D
AU  - Jenkin D
FAU - Dougherty, M
AU  - Dougherty M
FAU - Berry, M
AU  - Berry M
FAU - Balcolm, A
AU  - Balcolm A
AU  - et al.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Pediatr Surg
JT  - Journal of pediatric surgery
JID - 0052631
RN  - 1CC1JFE158 (Dactinomycin)
RN  - 5J49Q6B70F (Vincristine)
SB  - IM
MH  - Biopsy, Needle
MH  - Chemotherapy, Adjuvant
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Dactinomycin/*administration & dosage
MH  - Female
MH  - Humans
MH  - Infant
MH  - Kidney Neoplasms/*drug therapy/pathology/radiotherapy/surgery
MH  - Male
MH  - Vincristine/*administration & dosage
MH  - Wilms Tumor/*drug therapy/pathology/radiotherapy/surgery
EDAT- 1991/08/01 00:00
MHDA- 1991/08/01 00:01
CRDT- 1991/08/01 00:00
PHST- 1991/08/01 00:00 [pubmed]
PHST- 1991/08/01 00:01 [medline]
PHST- 1991/08/01 00:00 [entrez]
AID - S0022346891002579 [pii]
AID - 10.1016/0022-3468(91)90842-h [doi]
PST - ppublish
SO  - J Pediatr Surg. 1991 Aug;26(8):949-53; discussion 953-6. doi: 
      10.1016/0022-3468(91)90842-h.