Treatment of children with clear-cell sarcoma of the kidney: a report from the National Wilms' Tumor Study Group.

Abstract

PURPOSE:

To evaluate the effect of the sequential addition of doxorubicin (DOX) and cyclophosphamide (CTX) to the combination of vincristine (VCR) and dactinomycin (AMD) on the relapse-free survival of children with clear-cell sarcoma of the kidney (CCSK).

PATIENTS AND METHODS:

We determined the 6-year relapse-free survival rate for patients with CCSK treated on National Wilms' Tumor Study (NWTS)-1, NWTS-2, or NWTS-3 with the combination of VCR and AMD, with or without DOX, and for patients treated on NWTS-3 with the combination of VCR, AMD, and DOX with (regimen J) or without (regimen DD-RT) CTX.

RESULTS:

The 6-year relapse-free survival rate for the eight children with CCSK treated with VCR, AMD, and radiation therapy was 25.0%, compared with 63.5% for the 58 children treated with VCR, AMD, DOX, and radiation therapy (P = .09). The 6-year relapse-free survival rate for children with CCSK treated on regimen DD-RT was 64.6%, compared with 58.2% for those treated on regimen J (P = .79).

CONCLUSION:

We conclude that the addition of DOX to the combination of VCR plus AMD appeared to improve the 6-year relapse-free survival rate of children with CCSK. The addition of CTX in the dose and schedule used in NWTS-3 did not improve the 6-year relapse-free survival rate of children with CCSK. Because 30% of relapses occurred more than 2 years after diagnosis, prolonged follow-up evaluation of patients with CCSK is necessary.

• Authors: D M Green, N E Breslow, J B Beckwith, J Moksness, J Z Finklestein, G J D'Angio
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 12 Issue 10 Pg. 2132-7 (Oct 1994) ISSN: 0732-183X [Print] United States
• PMID: 7931484 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Dactinomycin
• Vincristine
• Doxorubicin
• Cyclophosphamide

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Child
• Child, Preschool
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage)
• Dactinomycin (administration & dosage)
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Female
• Humans
• Kidney Neoplasms (drug therapy, radiotherapy)
• Male
• Neoplasms, Germ Cell and Embryonal (drug therapy, radiotherapy)
• Proportional Hazards Models
• United States
• Vincristine (administration & dosage)
• Wilms Tumor