A total of nine children with previously untreated stage IV
Wilms' tumor of favorable histology were treated according to the Austrian/Hungarian
Wilms' Tumor Protocol 89 and received a preoperative single dose of
carboplatin as an "up front" window
therapy. The treatment consisted of
carboplatin as a single-dose of 600 mg/m2 over 30 minutes on day 1. Response evaluation by chest X-ray, serial CT scans, and sonography was performed on day 22. Investigation of the abdominal
tumors revealed seven partial responses (78%), one nonresponse, and one progressive disease with a median
tumor volume reduction of 62%. Response of
metastases evaluated by CT scans was as follows: four complete remission, four partial response, and one nonresponse.
Thrombocytopenia (WHO grade III 1, grade II 2, grade I 2) and
leukocytopenia (WHO grade II 1, grade I 5) were the main side effects. No renal or liver toxicity were observed. The overall response rate after a preoperative single-dose of 600 mg/m2
carboplatin in untreated patients with stage IV
Wilms' tumor is encouraging and the toxicity acceptable. This data indicate that
carboplatin seems to be an additional effective
drug in patients with previously untreated
Wilms' tumor of favorable histology.