Table 6. Overview of Standard Treatment Options for Stage IV Wilms Tumora

Histology4-Year RFS or EFS4-Year OSTreatment (refer to Table 2 for chemotherapy regimen descriptions)
FH76% RFS86%Nephrectomy + lymph node sampling, followed by abdominal XRT,b radiation to sites of metastases, bilateral pulmonary XRT,c and regimen DD-4A
FH (with isolated lung nodules)85% EFS96%Nephrectomy + lymph node sampling, followed by abdominal XRT,b +/- bilateral pulmonary XRT,c and regimen DD-4A or regimen Md
FA61% EFS72% (n = 11)Nephrectomy + lymph node sampling, followed by abdominal XRT,b radiation to sites of metastases, bilateral pulmonary XRT,c and regimen DD-4A
DA33% EFS33% (n = 15)Immediate nephrectomy + lymph node sampling followed by abdominal XRT,b radiation to sites of metastases, whole-lung XRT,c and regimen I
DA (preoperative treatment)31% EFS44% (n = 13)Preoperative treatment with regimen I followed by nephrectomy + lymph node sampling, followed by abdominal XRT,b radiation to sites of metastases, and whole-lung XRTc

DA = diffuse anaplasia; EFS = event-free survival; FA = focal anaplasia; FH = favorable histology; OS = overall survival; RFS = relapse-free survival; XRT = radiation therapy.

aSource: Grundy et al.[96], Dome et al.[137], and Dix et al.[203]

bAbdominal XRT is planned according to local stage of renal tumor.

cPulmonary XRT is reserved for patients with chest x-ray/chest CT evidence of pulmonary metastases.

dRefer to the AREN0533 (NCT00379340) study for more information.

From: Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®)

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PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
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