PMID- 9850017
OWN - NLM
STAT- MEDLINE
DCOM- 19990105
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 16
IP  - 12
DP  - 1998 Dec
TI  - Effect of duration of treatment on treatment outcome and cost of treatment for 
      Wilms' tumor: a report from the National Wilms' Tumor Study Group.
PG  - 3744-51
AB  - PURPOSE: National Wilms' Tumor Study (NWTS)-4 was designed to evaluate the 
      efficacy, toxicity, and cost of the administration of different regimens for the 
      treatment of Wilms' tumor (WT). PATIENTS AND METHODS: Between August 6, 1986 and 
      September 1, 1994, 905 previously untreated children aged younger than 16 years 
      with stage II favorable histology (FH) WT (low-risk [LR]), stages III to IV FH 
      WT, or stages I to IV clear-cell sarcoma of the kidney (high-risk[HR]) were 
      randomized after the completion of 6 months of chemotherapy to discontinue 
      (short) or continue for 9 additional months (long) treatment with chemotherapy 
      regimens that included vincristine and either divided-dose (standard [STD]) 
      courses (5 days) or single-dose (pulse-intensive [PI]) treatment with 
      dactinomycin. HR patients also received either divided-dose (STD) courses (3 
      days) or single-dose (PI) treatment with doxorubicin. RESULTS: The 4-year 
      relapse-free survival (RFS) rates after the second randomization for LR patients 
      were 83.7% for the 190 patients treated with short and 88.2% for the 187 patients 
      treated with long chemotherapy (P = .11). The 4-year RFS rates after the second 
      randomization for HR FH patients were 89.7% for the 256 patients treated with 
      short and 88.8% for the 246 patients treated with long chemotherapy (P = .87). 
      The charge for treatment with the short PI treatment regimens for all children 
      with stages I through IV FH WT was approximately one half of that with the long 
      STD treatment regimens. CONCLUSION: The short administration schedule for the 
      treatment of children with WT is no less effective than the long administration 
      schedule and can be administered at a substantially lower total treatment cost.
FAU - Green, D M
AU  - Green DM
AD  - Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. 
      green@sc3101.med.buffalo.edu
FAU - Breslow, N E
AU  - Breslow NE
FAU - Beckwith, J B
AU  - Beckwith JB
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
FAU - Haase, G
AU  - Haase G
FAU - Ritchey, M
AU  - Ritchey M
FAU - Kelalis, P
AU  - Kelalis P
FAU - D'Angio, G J
AU  - D'Angio GJ
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  - 0 (Antibiotics, Antineoplastic)
RN  - 0 (Antineoplastic Agents, Phytogenic)
RN  - 1CC1JFE158 (Dactinomycin)
RN  - 5J49Q6B70F (Vincristine)
RN  - 80168379AG (Doxorubicin)
SB  - IM
MH  - Adolescent
MH  - Antibiotics, Antineoplastic/administration & dosage
MH  - Antineoplastic Agents, Phytogenic/administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/*economics/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Cost-Benefit Analysis
MH  - Dactinomycin/administration & dosage
MH  - Doxorubicin/administration & dosage
MH  - Drug Administration Schedule
MH  - *Episode of Care
MH  - Female
MH  - *Health Care Costs
MH  - Humans
MH  - Infant
MH  - Kidney Neoplasms/*drug therapy/*economics/pathology
MH  - Male
MH  - Neoplasm Staging
MH  - Neoplasms, Germ Cell and Embryonal/*drug therapy/*economics/secondary
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
MH  - Vincristine/administration & dosage
MH  - Wilms Tumor/drug therapy/economics
EDAT- 1998/12/16 00:00
MHDA- 1998/12/16 00:01
CRDT- 1998/12/16 00:00
PHST- 1998/12/16 00:00 [pubmed]
PHST- 1998/12/16 00:01 [medline]
PHST- 1998/12/16 00:00 [entrez]
AID - 10.1200/JCO.1998.16.12.3744 [doi]
PST - ppublish
SO  - J Clin Oncol. 1998 Dec;16(12):3744-51. doi: 10.1200/JCO.1998.16.12.3744.