PMID- 8544795
OWN - NLM
STAT- MEDLINE
DCOM- 19960213
LR  - 20151119
IS  - 0098-1532 (Print)
IS  - 0098-1532 (Linking)
VI  - 26
IP  - 3
DP  - 1996 Mar
TI  - Treatment of children with stage IV favorable histology Wilms tumor: a report 
      from the National Wilms Tumor Study Group.
PG  - 147-52
AB  - The purpose of this study was to evaluate the effect of the sequential addition 
      of doxorubicin and cyclophosphamide to the combination of vincristine and 
      actinomycin D on the relapse-free survival of children with stage IV/favorable 
      histology Wilms tumor. We reviewed the clinical courses of all randomized 
      patients from National Wilms Tumor Study (NWTS)-2 and 3 with stage IV/favorable 
      histology (FH) Wilms tumor. We determined the four-year relapse-free survival 
      percentage for patients treated on NWTS-2 with the combination of vincristine 
      (VCR) and actinomycin D (AMD) with (regimen D) or without (regimen C) doxorubicin 
      (DOX), and for patients treated on NWTS-3 with the combination of VCR+AMD+DOX 
      with (regimen J) or without (regimen DD-RT) cyclophosphamide (CTX). All children 
      received whole lung radiation therapy. The four-year relapse-free survival 
      percentage for children with stage IV/FH Wilms tumor treated with regimen C was 
      53.3%, compared to 57.7% for those treated with regimen D (P = 0.63). The 
      four-year relapse-free survival percentage for children with stage IV/FH Wilms 
      tumor treated with regimen DD-RT was 79.0%, compared to 80.9% for those treated 
      on regimen J (P = 0.79). The four-year relapse-free survival for children with 
      lung metastases only treated with regimen D on NWTS-2 was significantly lower 
      than that of children treated with the related regimen DD-RT on NWTS-3 (P = 
      0.03). We conclude that the addition of doxorubicin to the combination of 
      vincristine and actinomycin D and pulmonary irradiation did not clearly improve 
      the four-year relapse-free survival percentage of children with stage IV/FH Wilms 
      tumor, although the benefit may have been masked by the greater frequency of 
      death due to toxicity in NWTS-2. There was no evidence that the addition of CTX 
      to the three-drug treatment regimen improved the four-year relapse-free survival 
      percentage of children with stage IV/FH Wilms tumor. The data with only two drugs 
      derived from NWTS-2 suggest that there is a population of children with stage 
      IV/FH Wilms tumor who can be successfully treated without an anthracycline. The 
      goal of future research will be to identify this subgroup at the time of initial 
      diagnosis.
FAU - Green, D M
AU  - Green DM
AD  - Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, New York 14263, 
      USA.
FAU - Breslow, N E
AU  - Breslow NE
FAU - Evans, I
AU  - Evans I
FAU - Moksness, J
AU  - Moksness J
FAU - D'Angio, G J
AU  - D'Angio GJ
LA  - eng
GR  - CA-42326/CA/NCI NIH HHS/United States
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Med Pediatr Oncol
JT  - Medical and pediatric oncology
JID - 7506654
RN  - 1CC1JFE158 (Dactinomycin)
RN  - 5J49Q6B70F (Vincristine)
RN  - 80168379AG (Doxorubicin)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Child
MH  - Combined Modality Therapy
MH  - Cyclophosphamide/administration & dosage
MH  - Dactinomycin/administration & dosage
MH  - Disease-Free Survival
MH  - Doxorubicin/administration & dosage
MH  - Humans
MH  - Neoplasm Staging
MH  - Vincristine/administration & dosage
MH  - Wilms Tumor/*drug therapy/pathology/radiotherapy
EDAT- 1996/03/01 00:00
MHDA- 2000/06/20 09:00
CRDT- 1996/03/01 00:00
PHST- 1996/03/01 00:00 [pubmed]
PHST- 2000/06/20 09:00 [medline]
PHST- 1996/03/01 00:00 [entrez]
AID - 10.1002/(SICI)1096-911X(199603)26:3<147::AID-MPO1>3.0.CO;2-K [pii]
AID - 10.1002/(SICI)1096-911X(199603)26:3<147::AID-MPO1>3.0.CO;2-K [doi]
PST - ppublish
SO  - Med Pediatr Oncol. 1996 Mar;26(3):147-52. doi: 
      10.1002/(SICI)1096-911X(199603)26:3<147::AID-MPO1>3.0.CO;2-K.