PMID- 22422736
OWN - NLM
STAT- MEDLINE
DCOM- 20121015
LR  - 20211021
IS  - 1545-5017 (Electronic)
IS  - 1545-5009 (Print)
IS  - 1545-5009 (Linking)
VI  - 59
IP  - 4
DP  - 2012 Oct
TI  - Clinical significance of pulmonary nodules detected by CT and Not CXR in patients 
      treated for favorable histology Wilms tumor on national Wilms tumor studies-4 and 
      -5: a report from the Children's Oncology Group.
PG  - 631-5
LID - 10.1002/pbc.24123 [doi]
AB  - BACKGROUND: Metastatic lung disease in Wilms tumor (WT) patients was 
      traditionally identified by chest radiograph (CXR). It is unclear whether 
      patients with small lesions, detectable only by computed tomography ("CT-only" 
      lesions), require the more intensive therapy, including doxorubicin and lung 
      irradiation, given to patients with metastases detectable by CXR. PROCEDURES: 
      This study involved 417 patients with favorable histology WT and isolated lung 
      metastases (detected by CXR or CT) who were registered on National Wilms tumor 
      Study (NWTS)-4 or -5. Outcomes by method of detection (CXR vs. CT-only), use of 
      lung radiation, and 2- or 3-drug chemotherapy (dactinomycin and vincristine +/- 
      doxorubicin) were determined and compared using the log-rank test. RESULTS: There 
      were 231 patients with lung lesions detected by CXR and 186 by CT-only. Of the 
      patients with CT-only nodules, 37 received only 2 drugs and 101 did not receive 
      lung radiation. Five-year event-free survival (EFS) was greater for patients 
      receiving three drugs (including doxorubicin) with or without lung radiation than 
      for those receiving two drugs (80% vs. 56%; P = 0.004). There was no difference 
      seen in 5-year overall survival (OS) between the 3- and 2-drug subsets (87% vs. 
      86%; P = 0.91). There were no significant differences in EFS (82% vs. 72%; P = 
      0.13) or OS (91% vs. 83%; P = 0.46) for patients with CT-only nodules whether 
      they received lung radiation or not. CONCLUSIONS: Our results suggest that 
      patients with CT-only lung lesions may have improved EFS but not OS from the 
      addition of doxorubicin but do not appear to benefit from pulmonary radiation.
CI  - Copyright (c) 2012 Wiley Periodicals, Inc.
FAU - Grundy, Paul E
AU  - Grundy PE
AD  - Department of Pediatrics and Oncology, University of Alberta, Edmonton Canada. 
      paul.grundy@albertahealthservices.ca
FAU - Green, Daniel M
AU  - Green DM
FAU - Dirks, Astrid C
AU  - Dirks AC
FAU - Berendt, Andrea E
AU  - Berendt AE
FAU - Breslow, Norman E
AU  - Breslow NE
FAU - Anderson, James R
AU  - Anderson JR
FAU - Dome, Jeffrey S
AU  - Dome JS
LA  - eng
GR  - CA98543/CA/NCI NIH HHS/United States
GR  - U10 CA042326-18S1/CA/NCI NIH HHS/United States
GR  - R01 CA054498/CA/NCI NIH HHS/United States
GR  - U10 CA098543/CA/NCI NIH HHS/United States
GR  - U10 CA098543-01/CA/NCI NIH HHS/United States
GR  - CA42326/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20120315
PL  - United States
TA  - Pediatr Blood Cancer
JT  - Pediatric blood & cancer
JID - 101186624
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Kidney Neoplasms/*pathology/therapy
MH  - Lung Neoplasms/*diagnostic imaging/*secondary
MH  - Male
MH  - Nephrectomy
MH  - *Radiography, Thoracic
MH  - *Tomography, X-Ray Computed
MH  - Wilms Tumor/*diagnostic imaging/*secondary/therapy
PMC - PMC3397278
MID - NIHMS356503
COIS- Authors' Disclosures of Potential Conflicts of Interest The authors do not 
      disclose any conflicts of interest.
EDAT- 2012/03/17 06:00
MHDA- 2012/10/16 06:00
PMCR- 2013/10/01
CRDT- 2012/03/17 06:00
PHST- 2011/10/06 00:00 [received]
PHST- 2012/02/08 00:00 [accepted]
PHST- 2012/03/17 06:00 [entrez]
PHST- 2012/03/17 06:00 [pubmed]
PHST- 2012/10/16 06:00 [medline]
PHST- 2013/10/01 00:00 [pmc-release]
AID - 10.1002/pbc.24123 [doi]
PST - ppublish
SO  - Pediatr Blood Cancer. 2012 Oct;59(4):631-5. doi: 10.1002/pbc.24123. Epub 2012 Mar 
      15.