PMID- 7931483
OWN - NLM
STAT- MEDLINE
DCOM- 19941104
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 12
IP  - 10
DP  - 1994 Oct
TI  - Treatment of children with stages II to IV anaplastic Wilms' tumor: a report from 
      the National Wilms' Tumor Study Group.
PG  - 2126-31
AB  - PURPOSE: To evaluate the effect of the combination of vincristine, dactinomycin, 
      and doxorubicin with (regimen J) or without (regimen DD-RT) cyclophosphamide on 
      the relapse-free survival of children with stages II to IV Wilms' tumor and focal 
      or diffuse anaplasia. PATIENTS AND METHODS: We reviewed the clinical courses of 
      all randomized patients from National Wilms' Tumor Study (NWTS)-3 and NWTS-4 with 
      stages II to IV anaplastic Wilms' tumor, and determined the 4-year relapse-free 
      survival rate separately for those with focal or diffuse anaplasia. Anaplasia was 
      evaluated using newly developed topographic definitions for focal and diffuse 
      anaplasia. RESULTS: The 4-year relapse-free survival rate for five children with 
      focal anaplasia who received regimen DD-RT was 80.0%, compared with 100.0% for 
      eight children who received regimen J (P = .68). The 4-year relapse-free survival 
      rate for 29 children with diffuse anaplasia treated with regimen DD-RT was 27.2%, 
      compared with 54.8% for 30 children treated with regimen J (P = .02). CONCLUSION: 
      We conclude that children with focal anaplasia have an excellent prognosis when 
      treated with vincristine, doxorubicin, and dactinomycin. The addition of 
      cyclophosphamide to the three-drug treatment regimen improved the 4-year 
      relapse-free survival rate of children with stage II to IV diffuse anaplasia. 
      This result suggests that further intensification of the treatment regimen for 
      children with diffuse anaplasia may result in an additional improvement in 
      prognosis.
FAU - Green, D M
AU  - Green DM
AD  - Department of Pediatrics, Roswell Park Cancer Institute, School of Medicine, 
      State University of New York at Buffalo 14263.
FAU - Beckwith, J B
AU  - Beckwith JB
FAU - Breslow, N E
AU  - Breslow NE
FAU - Faria, P
AU  - Faria P
FAU - Moksness, J
AU  - Moksness J
FAU - Finklestein, J Z
AU  - Finklestein JZ
FAU - Grundy, P
AU  - Grundy P
FAU - Thomas, P R
AU  - Thomas PR
FAU - Kim, T
AU  - Kim T
FAU - Shochat, S
AU  - Shochat S
AU  - et al.
LA  - eng
GR  - CA-42326/CA/NCI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 1CC1JFE158 (Dactinomycin)
RN  - 5J49Q6B70F (Vincristine)
RN  - 80168379AG (Doxorubicin)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Anaplasia
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Cyclophosphamide/administration & dosage
MH  - Dactinomycin/administration & dosage
MH  - Disease-Free Survival
MH  - Doxorubicin/administration & dosage
MH  - Female
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy/pathology/radiotherapy
MH  - Male
MH  - Neoplasm Staging
MH  - Prognosis
MH  - United States
MH  - Vincristine/administration & dosage
MH  - Wilms Tumor/*drug therapy/pathology/radiotherapy
EDAT- 1994/10/01 00:00
MHDA- 1994/10/01 00:01
CRDT- 1994/10/01 00:00
PHST- 1994/10/01 00:00 [pubmed]
PHST- 1994/10/01 00:01 [medline]
PHST- 1994/10/01 00:00 [entrez]
AID - 10.1200/JCO.1994.12.10.2126 [doi]
PST - ppublish
SO  - J Clin Oncol. 1994 Oct;12(10):2126-31. doi: 10.1200/JCO.1994.12.10.2126.