Progress in treatment of bilateral Wilms'tumor
10.3969/j.issn.1000-8179.2018.21.908
- VernacularTitle:双侧肾母细胞瘤临床治疗进展
- Author:
Hongyan NIE
1
Author Information
1. 天津医科大学肿瘤医院儿童肿瘤科
- Keywords:
bilateral Wilms'tumors;
anaplasia;
chemotherapy;
nephron-sparing surgery;
radiotherapy
- From:
Chinese Journal of Clinical Oncology
2018;45(21):1122-1124
- CountryChina
- Language:Chinese
-
Abstract:
Bilateral Wilms'tumor (BWT) affects approximately 5% of children with WT. The goal of treatment in BWT is to preserve normal renal function as much as possible, in order to postpone and reduce the risk of end-stage renal disease and other long-term complications. For neoadjuvant chemotherapy, vincristine/dactinomycin/doxorubicin is used in cases with favorable histology. Cases with diffuse anaplasia or other unfavorable histology receive an intensified regimen, including additional agents such as ifosfamide, cy-clophosphamide, carboplatin, and others. Nephron-sparing surgery is performed to preserve long-term renal function. Radiotherapy is given according to local staging, when margins or lymph nodes are positive, or tumor spillage has occurred, or pathological type is ana-plasia. The survival rate of relapsed BWT is low. Some experts suggest that patients with recurrent BWT are most likely to benefit from high-dose therapy including stem-cell transplantation, but this remains controversial.
