Wilms' tumor: Reduced-dose radiotherapy in advanced-stage Wilms' tumor with favorable histology

Robert L. Tobin, James Fontanesi, Larry E. Kun, Diane L. Fairclough, H. Omar Hustu, William J. Pao, Edwin C. Douglass, Judith Wilimas, A. P. Mahesh Kumar, Jesse J. Jenkins

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3 Scopus citations

Abstract

Fifty-two children with favorable histology Wilms' tumor who had residual abdominal disease (Surgical Stages III and IV) were treated from 1979 to 1988 on a protocol designed to assess the effectiveness of reduced radiation doses. All patients received three-agent chemotherapy, beginning within 1 week after surgery. To permit assessment of disease response to initial chemotherapy, radiation therapy was delayed for a median of 28 days after surgery (range, 14-71 days). Total doses of abdominal radiation were limited to 12 Gy, given as 150 cGy daily fractions; 18 patients with Stage IV disease received 12 Gy bilateral pulmonary irradiation. Two year disease-free survival was 85% and 71% for Stage III and IV, respectively (p = .24). Abdominal relapses occurred in 3 cases (5.7%). The interval between surgery and initiation of irradiation was not related to disease-free survival. Of several patient and disease-related factors analyzed, only patient age was related to outcome. Disease-free survival was 100% at 3 years for children under the age of 3 versus 78% for children greater than age 3 (p = .05). Reduced-dose abdominal radiotherapy in conjunction with multi-agent chemotherapy and surgery provided excellent disease control with minimal toxicity in advanced-stage, favorable histology Wilms' tumor.

Original languageEnglish (US)
Pages (from-to)867-871
Number of pages5
JournalInternational journal of radiation oncology, biology, physics
Volume19
Issue number4
DOIs
StatePublished - Oct 1990

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Keywords

  • Abdominal irradiation
  • Combination therapy
  • Wilms' tumor

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Tobin, R. L., Fontanesi, J., Kun, L. E., Fairclough, D. L., Hustu, H. O., Pao, W. J., Douglass, E. C., Wilimas, J., Mahesh Kumar, A. P., & Jenkins, J. J. (1990). Wilms' tumor: Reduced-dose radiotherapy in advanced-stage Wilms' tumor with favorable histology. International journal of radiation oncology, biology, physics, 19(4), 867-871. https://doi.org/10.1016/0360-3016(90)90006-6