Timing of Radiation Therapy in Pediatric Wilms Tumor: A Report From the National Cancer Database

Stokes, Claire; Stokes, William A.; Kalapurakal, John A.; Paulino, Arnold dela Cruz; Cost, Nicholas G.; Cost, Carrye R.; Garrington, Timothy P.; Greffe, Brian; Roach, Jonathan P.; Bruny, Jennifer; Liu, Arthur K.

doi:10.1016/j.ijrobp.2018.01.110

Cited by 28 publications

(24 citation statements)

References 22 publications

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“…The National Cancer Database (NCDB) reports that for non-metastatic patients, surgery to radiotherapy interval ≤ 14 days correlates with improved overall survival. However, no association was noted for patients with metastases [28].…”

Section: Local Radiotherapymentioning

confidence: 82%

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

El‐Ayadi

Magdy

Khalil

et al. 2020

J Egypt Natl Canc Inst

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Background: Wilms' tumor (WT) is the most common renal malignant tumor of childhood. Metastatic WT has a worse prognosis than localized disease. This study aims to assess the clinical outcome and different prognostic factors that influence treatment outcome of pediatric metastatic WT cases treated at National Cancer Institute (NCI), Egypt, between January 2008 and December 2015. Medical records were retrospectively reviewed for clinical, radiological and histopathological data, treatment received, and survival outcome.Results: In the specified study period, 24/103 (23.3%) patients with WT were metastatic at presentation. The mean age was 5.25 ± 2.87 years (range 2.0-12.7). Abdominal swelling/mass was the commonest presentation (70.8%). Only 3 patients (12.5%) had combined lung and liver metastases while 21 patients (87.5%) had pulmonary-only metastases. All patients had favorable histology tumors with no anaplasia. Nine patients (37.5%) underwent upfront nephrectomy. Majority of patients (91.7%) had local stage III disease. Surgical complications were reported in 4 patients; 3 of them had up-front nephrectomy. Only 7/21 patients achieved rapid complete response of pulmonary nodules after 6 weeks of chemotherapy (CTH), and they had a better survival outcome. Patients were followed up till December 2017. Thirteen patients (54.1%) experienced events during the study period including 5 relapses, 6 cases with disease progression, and 2 patients died out of sepsis. The 3-year event-free and overall survival rates were 48.2% and 54.2%, respectively. Conclusion: Neo-adjuvant CTH followed by delayed nephrectomy seems more suitable approach in our institute. Pulmonary response to neo-adjuvant CTH appears to be a strong predictor for outcome.

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Section: Local Radiotherapymentioning

confidence: 82%

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

El‐Ayadi

Magdy

Khalil

et al. 2020

J Egypt Natl Canc Inst

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“…La dosis varía según la edad, zona a irradiar, estadio y respuesta quimioterapéutica. Esta oscila entre 10,8 a 21 Gy y cuando se cumple en menos de 14 días se relaciona con una mejor supervivencia (Stokes et al, 2018).…”

Section: Discussionunclassified

Tumor de Wilms: Estudio de Centro Único de Los Andes Ecuatorianos. Serie de Casos con Seguimiento

Guerrero

Alvarado²,

Urdiales³

et al. 2020

Int. J. Morphol.

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RESUMEN: El Tumor de Wilms (TW) es el tumor renal más frecuente entre los 1 y 5 años de edad. La evidencia existente respecto de aspectos clínicos, terapéuticos y de supervivencia (SV) del TW es escasa. El objetivo de este estudio fue determinar diferencias en la SV actuarial global (SVAG) y SV libre de enfermedad (SVLE) a 5 años en pacientes con TW tratados con quimioterapia neoadyuvante (QTNA) y cirugía inicial (CI). Serie de casos. Se incluyeron pacientes con TW de 11 meses y 13 años de edad, tratados en el Instituto del Cáncer SOLCA, Cuenca (1994-2019). Las variables resultado fueron SVAG y SVLE a 5 años. Otras variables de interés fueron: localización, estadio, histología, seguimiento y remisión completa (RC). Una vez concluidos sus tratamientos, los pacientes fueron sometidos a un seguimiento clínico. Se utilizó estadística descriptiva (medidas de tendencia central y dispersión) y analítica (Chi2, exacto de Fisher y corrección por continuidad). Se realizaron análisis de SV con curvas de Kaplan Meier y log-rank. Se reclutaron 36 pacientes (52,8 % hombres), con una mediana de edad de 44 meses; 55,5 % de ellos tuvieron histología favorable. La localización y estadio más frecuente fue riñón izquierdo (55,5 %) y I (33,3 %) respectivamente. El 58,3 % fueron sometidos a CI y el 41,7 % QTNA. Luego de aplicados los tratamientos 21 pacientes (58,3 %), alcanzaron RC. La SVAG y SVLE general a 5 años fue 72,0 % y 69,0 % respectivamente. Al comparar los subgrupos con QTNA y CI; se verificaron SVAG y SVLE a 5 años de 60,0 % y 81,0 % (p=0,118); y de 66,7 % y 71,4 % (p=0,536) respectivamente. La SVAG y SVLE verificadas son similares a las reportadas en otros estudios. No se evidenciaron diferencias de éstas con los tratamientos QTNA y CI.

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“…However, no difference in LC was found if RT was delayed > 10 days from surgery for patients with stage II‐IV FH treated on NWTS‐3 or ‐4 22 . More recent data from the National Cancer Database (NCDB) confirm improved survival in nonmetastatic Wilms tumor patients who received adjuvant RT ≤ 14 days postoperatively 23 …”

Section: Role Of Radiotherapymentioning

confidence: 99%

Wilms tumor

Pater

Melchior

Rübe

et al. 2020

Pediatric Blood & Cancer

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The objectives for the treatment of Wilms tumor in both the Children's Oncology Group (COG) and the International Society of Paediatric Oncology (SIOP) have focused on improving cure rates and minimizing toxicity by limiting the use of radiation and doxorubicin. Although the timing of surgery is different in COG (upfront surgery) and SIOP (upfront chemotherapy with delayed surgery), both are effective strategies and have the same survival. Fewer patients are treated with radiotherapy in the SIOP trials but with higher doses. The prognostic significance of biological markers such as 1q gain and clinical outcomes with novel radiation techniques such as intensity modulated radiation therapy will be determined in upcoming clinical trials. A closer collaboration between COG and SIOP could help promote research and improve the clinical outcomes of children with Wilms tumor.

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Timing of Radiation Therapy in Pediatric Wilms Tumor: A Report From the National Cancer Database

Cited by 28 publications

References 22 publications

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

Management and outcome of pediatric metastatic Wilms’ tumor at the National Cancer Institute, Egypt

Tumor de Wilms: Estudio de Centro Único de Los Andes Ecuatorianos. Serie de Casos con Seguimiento

Wilms tumor

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