Surgery, radiation therapy, and chemotherapy

Fifty-eight patients were treated on the NWTS-5 relapse protocol with surgical excision when feasible, radiation therapy, and courses of vincristine, doxorubicin, and cyclophosphamide alternating with etoposide and cyclophosphamide.[307]

Fifty-eight patients were treated on the NWTS-5 relapse protocol with surgical excision when feasible, radiation therapy, and courses of vincristine, doxorubicin, and cyclophosphamide alternating with etoposide and cyclophosphamide.[307]

The 4-year EFS rate after relapse was 71%, and the OS rate was 82%.

Fifty-eight patients were treated on the NWTS-5 relapse protocol with surgical excision when feasible, radiation therapy, and courses of vincristine, doxorubicin, and cyclophosphamide alternating with etoposide and cyclophosphamide.[307]

For patients whose site of relapse was only the lungs, the 4-year EFS rate was 68%, and the OS rate was 81%.

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

The postrelapse 5-year EFS rate was 72.3%, and the OS rate was 79.3%.

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

Patients treated with vincristine, dactinomycin, and doxorubicin (VAD) did not fare worse than patients treated with more intensive therapies (such as cyclophosphamide, carboplatin, etoposide, and doxorubicin or ifosfamide, carboplatin, and etoposide [ICE] backbones; HR for EFS, 0.611; HR for OS, 0.438).

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

There was no survival difference between patients treated with VAD compared with ICE-based regimens.

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

The type of alkylating agent (ifosfamide or cyclophosphamide) used in more intensive treatment regimens did not affect survival rates.

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

Incorporation of high-dose hematopoietic stem cell transplant (HSCT) to consolidate relapse treatment did not improve the outcome for standard-risk relapse patients.

The SIOP Renal Tumor Study Group (SIOP-RTSG) analyzed the outcomes of low- and intermediate-risk patients (n = 109) who relapsed after treatment with vincristine and dactinomycin for primary Wilms tumor from their SIOP 93-01 and SIOP 2001 studies.[309][Level of evidence: C1]

Future studies may be able to identify patients who may benefit from VAD treatment rather than more intensive treatment with combination chemotherapy including cyclophosphamide, carboplatin, etoposide, and doxorubicin.