4/24/2020 Relapsed Wilms tumor: is there a role for radiation therapy?

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Format: Abstract

Am J Clin Oncol. 2001 Aug;24(4):408-13.

Relapsed Wilms tumor: is there a role for radiation therapy?

Paulino AC1.

Author information

Abstract
From 1968 to 1996, 21 of 97 (22%) patients with Wilms tumor treated at the University of Iowa
Hospitals and Clinics relapsed after initial therapy. The most common sites of initial recurrence were
the lungs in 12 (57%), abdomen in 3 (14%), bone in 3 (14%), and liver in 2 (10%). Treatment for
recurrence included chemotherapy in 16, radiotherapy in 15 and surgery in 8. Radiotherapy was
given to bilateral lungs of 8 previously untreated chests; total dose was 1,200 cGy to 1,500 cGy, with
2 patients receiving 1,000-cGy boost. One patient had abdominal radiotherapy after surgery for
relapse; six patients had palliative radiotherapy to distant sites. The 1-, 3-, and 5-year postrelapse
survivals were 62 +/- 11%, 38 +/- 11%, and 33 +/- 10%, respectively. Using Cox proportional-hazard
regression models, abdominal recurrence (p = 0.0002; hazard ratio, 39.5) and initial stage IV disease
(p = 0.019; hazard ratio, 6.27) were found to have a negative impact on postrelapse survival. Seven
patients with previously nonirradiated chests are alive at a median follow-up of 123 months after
relapse (range, 55--272 months); all had whole lung irradiation with or without chemotherapy at
relapse for lung metastases. Radiotherapy was also found to be an effective treatment in the
palliation of painful metastases.

PMID: 11474275 DOI: 10.1097/00000421-200108000-00022

[Indexed for MEDLINE]

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https://www.ncbi.nlm.nih.gov/pubmed/11474275 1/2
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https://www.ncbi.nlm.nih.gov/pubmed/11474275 2/2