RT Journal Article
T1 Is radiotherapy required in first-line treatment of stage I diffuse anaplastic Wilms tumor? A report of SIOP-RTSG, AIEOP, JWiTS, and UKCCSG.
A1 Davila-Fajardo, Raquel
A1 van-den-Heuvel-Eibrink, Marry M
A1 van-Tinteren, Harm
A1 Spreafico, Filippo
A1 Acha, Thomas
A1 Bergeron, Christophe
A1 de-Camargo, Beatriz
A1 Oldenburger, Foppe
A1 Rube, Christian
A1 Oue, Takaharu
A1 Vokuhl, Christian
A1 de-Krijger, Ronald R
A1 Vujanic, Gordan
A1 Sebire, Neil
A1 Coulomb-L'Hermine, Aurore
A1 Collini, Paola
A1 Gandola, Lorenza
A1 Pritchard-Jones, Kathy
A1 Graf, Norbert
A1 Janssens, Geert O
A1 van-Grotel, Martine
K1 Wilms tumor
K1 Diffuse anaplasia
K1 Radiotherapy
K1 Stage I
AB As a significant proportion of relapses occurred in the tumor bed or abdomen on patients with the fifth National Wilms Tumor Study stage I anaplastic Wilms tumor (WT), flank radiotherapy was added for stage I anaplastic WT in the subsequent study of the Children's Oncology Group (AREN0321). Preliminary results revealed reduction of relapse rate and improved survival. In cases treated with preoperative chemotherapy, such as in International Society of Pediatric Oncology (SIOP), the value of radiotherapy has never been studied. The aim of this observational study is to describe the pattern of recurrence and survival of patients with stage I diffuse anaplastic WT (DAWT) after induction chemotherapy. Retrospective data analysis of the pattern of relapse and survival of all patients with stage I DAWT were included in recent SIOP, L'Associazone Italiana Ematologica Oncologia Pediatrica (AIEOP), Japan Wilms Tumor Study Group (JWiTS), United Kingdom Children's Cancer Study Group (UKCCSG) renal tumor registries. Postoperative treatment consisted of actinomycin D, vincristine, and doxorubicin for 28 weeks without local irradiation. One hundred nine cases with stage I DAWT were identified, of which 95 cases received preoperative chemotherapy. Of these, seven patients underwent preoperative true-cut biopsy. Sixteen of the 95 patients relapsed (17%), six locally, four at distant site, and six combined, and all treated according to SIOP 2001 relapse protocol, which resulted in a 5-year overall survival of 93%. Despite 13% locoregional relapse rate, an excellent rescue rate was achieved after salvage treatment, in patients with stage I DAWT whose first-line treatment comprised three-drug chemotherapy (including doxorubicin), without flank irradiation. Therefore, we continue not to advocate the use of radiotherapy in first-line treatment after preoperative chemotherapy in stage I DAWT in the next SIOP protocol.
PB Wiley Periodicals
YR 2019
FD 2019-12-19
LK http://hdl.handle.net/10668/14933
UL http://hdl.handle.net/10668/14933
LA en
NO Fajardo RD, van den Heuvel-Eibrink MM, van Tinteren H, Spreafico F, Acha T, Bergeron C, et al. Is radiotherapy required in first-line treatment of stage I diffuse anaplastic Wilms tumor? A report of SIOP-RTSG, AIEOP, JWiTS, and UKCCSG. Pediatr Blood Cancer. 2020 Feb;67(2):e28039
DS RISalud
RD Apr 19, 2025