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The management of Wilms' tumour
Abstract
Th:s report is based essentially on 45 patients with Wilms' tumour treated during the period 1951 - 1967 with comments on a modified regime in 20 patients treaed since 1968. During the period 1951 - 1967 the standard treatment was nephrec:omy and radiotherapy; cy:oxics were added from 1959. The overall long-term survival was 42%, but all infants under the age of 1 Year have survived. Cytoxics increased the over-all survival rate from 19% to 55%. Although we aimed at giving pos~operative irradiation only, 10 patients received pre-operarve therapy because of the enormous size of their tumours and/or malnu:rit1on. Eight of these patients have survived. In view of the above, all patients, excepting infants under 1 year, have received pre- and postoperative X-ray therapy since 1968. We have also modified the cytoxic regime and all patien~s have been given repeated courses of actinomycin 0, while those with metastases or recurrence have also received vincristine. The over-all survival rate to date [s 60%.