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Treatment and prognosis in Wilms' tumor. A study of 51 cases with special reference to the role of actinomycin D
Author(s) -
Maier John G.,
Harshaw William G.
Publication year - 1967
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(1967)20:1<96::aid-cncr2820200115>3.0.co;2-2
Subject(s) - medicine , wilms' tumor , nephrectomy , radiation therapy , survival rate , surgery , oncology , kidney
A total of 51 patients with Wilms' tumor have been treated at Walter Reed General Hospital in 16 years. The 2‐year survival rate was 44% and the 3‐year survival rate 42%. Most patients had nephrectomy followed by postoperative irradiation. Patients treated after 1960 received actinomycin D either in the immediate postoperative period in conjunction with irradiation or subsequently when metastases developed. The addition of actinomycin D has not influenced the cure rate. However, the methods of treatment selection and the total number of cases prohibits proper staistical analysis. In addition, the immediate use of actinomycin D in the postoperative period along with irradiation has not prolonged survival. When actinomycin D has been reserved for subsequent use for later metastases or recurrent tumor there appears to be a definite increase in survival time. Both radiation therapy alone and combined with actinomycin D has been quite effective in controlling lung metastases. The complications of irradiation and actinomycin D in the treatment of Wilms' tumor have been briefly reviewed and found to be minimal in the present series.