According to an article recently published in the European Journal of Cancer, chemotherapy prior to surgery allows children with Wilms’ tumor to skip treatment with radiation and the chemotherapy agent Adriamycin® (doxorubicin), which are each associated with long-term side effects.
Wilms’ tumor is a rare childhood cancer of the kidney that affects roughly 500 children in the U.S. each year. Survival is generally good; more than 90% of children survive for at least four years after diagnosis. Treatment often involves surgery and chemotherapy and may also include radiation therapy. Because of this favorable prognosis, researchers continue to evaluate ways to reduce side effects of treatment, particularly long-lasting side effects, while maintaining effectiveness.
Researchers from England recently conducted a clinical trial to evaluate the effectiveness of chemotherapy prior to surgery among pediatric patients with Wilms’ tumor. This trial included 205 patients diagnosed with Wilms’ tumor that had not spread to distant sites in the body.
One group of patients was treated with preoperative chemotherapy, followed by surgery, while the other group of patients underwent immediate surgery. Both groups were then treated with chemotherapy following surgery; chemotherapy approaches were determined by the aggressiveness of the cancer as well as the amount of spread of cancer.
- At five years, overall survival was 89% in both groups of patients.
- Twenty percent of patients who were treated with Preoperative chemotherapy maintained their outcomes without treatment with radiation therapy and Adriamycin.
The researchers concluded that children with Wilms’ tumor that has not spread to distant sites in the body should be treated with preoperative chemotherapy because this approach appears to maintain effectiveness while avoiding side effects from radiation therapy and Adriamycin.
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Parents with children who have Wilms’ tumor may wish to speak with their physician regarding their individual risks and benefits of preoperative chemotherapy.
Reference: Mitchella C, Pritchard-Jonesb K, Shannon R, et al. Immediate Nephrectomy Versus Preoperative Chemotherapy in the Management of Non-Metastatic Wilms’ Tumour: Results of a Randomised Trial (UKW3) by the UK Children’s Cancer Study Group. European Journal of Cancer. 2006; 42:2554-2562.
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