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Considerations in the radiation therapy of Wilms' tumor
582
ABSTRACTS
studies most useful were IVP and venaeavagram. Ten patients were admitted with pulmonary metastases while 16 developed them later. There were three bilateral tumors on admission and three cases with initial involvement on one side only but developing a lesion on the other side within 5 mo after treatment. Triple therapy with surgery, chemotherapy, and radiotherapy is their present treatment plan.--S. Kim
Wilms' Tumor--An Interdisciplinary Treatment Program with and Without Dactinomycin. L. W. Margales, W, B. Smith, W. M. Wara, J. H. Kushner, and A. A. de Lorimier. Cancer 32:618622 (September), 1973.
This report compares Wilms' tumor patients treated with and without chemotherapy 9 Since 1962, 18 out of 22 with chemotherapy are alive. This compares to 10 out of 21 before 1962 and prior to chemotherapy. There were no survivors among nine patients with pulmonary metastases who were treated with radiotherapy but without chemotherapy. Lately, however, three out of six with both chemotherapy and radiotherapy for pulmonary metastases are now alive 2 yr or longer. Whereas 45~0 of patients developed pulmonary metastases prior to actinomycin, with maintenance chemotherapy, two out of 18 have developed pulmonary metastases. The authors feel that chemotherapy must be given intermittently for at least 15 rod. S. Kim
Considerations in the Radiation Therapy of Wilms' Tumor. J. R. Cassady, M. Tefft, R. M. Filler, M. Jaffe, and S. Hellman. Cancer 32:598608 (September), 1973.
One hundred and fifty-six patients from 1960 to 1970 are analyzed at the Children's Hospital in Boston. Excepting for five cases not treated with x-ray, all patients received surgery, chemotherapy, and radiotherapy. In those cases in which the t u m o r was greater than 550 g or there was major extrarenal vascular involvement, the prognosis was poorest. In the overall series, local recurrence after 2500 3000 rads was almost uniformly fatal. N o patient with proved hepatic disease survived. Pulmonary disease not controlled initially was rarely controlled at all.--S. Kim
Pelvic Neuroblastoma:
A
Better
Prognosis.
S. Ghasali. Ann. Surg. 179:115, 1974.
Seven children with pelvic neuroblastoma between the ages of 2 wk and 1 yr 1 I m o at the time of diagnosis are described. In four of the
children, the presenting symptom was acute retention of urine and in the other three, the t u m o r was palpated at birth or soon after. No abnormality was detected on bone marrow examination in the two children who had this test performed. Skeletal survey and chest x-rays of all the children showed no distant metastases. The liver was not involved in any of the children. lilac lymph nodes were replaced by metastatic tumor in two children. Complete excision of the tumor was not possible in any of the seven children. Only a biopsy was performed in one child, and in two children a partial excision of t u m o r was performed on more than one occasion. All except one child were given vitamin BI~" for varying periods of time. One child was given radiotherapy 9 Histologic examination of the excised specimen showed it to be a cellular neuroblastoma with a high degree of malignancy in five children. Six children are alive after treatment and they are now 22, 20, 17, 16, 14, and 10 yr of age. One child died at the age of 3 yr 5 mo and autopsy confirmed that the t u m o r had undergone spontaneous regression. Death had occurred from intestinal obstruction subsequent to band adhesions from previous surgery. At present, the author does not recommend vitamin BI2 in the treatment of neuroblastoma. The better prognosis is considered to be due to the young age at the time of presentation and the site of the tumor. Frank G. DeLuca
Combined Radical Surgery, Radiation Therapy, and Chemotherapy in Infants With Vulvavaginal Embryonal Rhabdomyosarcoma. M. S. Piver, J. J. Barlow, J. K, Wang, and N. K. Shah. Obstet. Gynecol. 42:522-526 (October), 1973.
Three short-term follow ups of patients at ages 10, 11, and 15 mo with vaginal rhabdomyosarcoma are presented. The first child presented with a labial lesion and underwent radical vulvectomy and bilateral inguinal lymphadenectomy, followed by radiation therapy, actinomycin D, and vincristine. The patient is now 21 mo without disease. The second patient underwent total pelvic exenteration, radiotherapy, vincristine, and cyclophosphamide for a vaginal lesion and is 8 mo without disease. The third child underwent vaginectomy and a modified radical hysterectomy, radiation therapy, actinomycin D, and vincristine. That patient is now 5 mo without disease9 The authors feel that triple therapy is the treatment of choice. S . Kim
ABSTRACTS
studies most useful were IVP and venaeavagram. Ten patients were admitted with pulmonary metastases while 16 developed them later. There were three bilateral tumors on admission and three cases with initial involvement on one side only but developing a lesion on the other side within 5 mo after treatment. Triple therapy with surgery, chemotherapy, and radiotherapy is their present treatment plan.--S. Kim
Wilms' Tumor--An Interdisciplinary Treatment Program with and Without Dactinomycin. L. W. Margales, W, B. Smith, W. M. Wara, J. H. Kushner, and A. A. de Lorimier. Cancer 32:618622 (September), 1973.
This report compares Wilms' tumor patients treated with and without chemotherapy 9 Since 1962, 18 out of 22 with chemotherapy are alive. This compares to 10 out of 21 before 1962 and prior to chemotherapy. There were no survivors among nine patients with pulmonary metastases who were treated with radiotherapy but without chemotherapy. Lately, however, three out of six with both chemotherapy and radiotherapy for pulmonary metastases are now alive 2 yr or longer. Whereas 45~0 of patients developed pulmonary metastases prior to actinomycin, with maintenance chemotherapy, two out of 18 have developed pulmonary metastases. The authors feel that chemotherapy must be given intermittently for at least 15 rod. S. Kim
Considerations in the Radiation Therapy of Wilms' Tumor. J. R. Cassady, M. Tefft, R. M. Filler, M. Jaffe, and S. Hellman. Cancer 32:598608 (September), 1973.
One hundred and fifty-six patients from 1960 to 1970 are analyzed at the Children's Hospital in Boston. Excepting for five cases not treated with x-ray, all patients received surgery, chemotherapy, and radiotherapy. In those cases in which the t u m o r was greater than 550 g or there was major extrarenal vascular involvement, the prognosis was poorest. In the overall series, local recurrence after 2500 3000 rads was almost uniformly fatal. N o patient with proved hepatic disease survived. Pulmonary disease not controlled initially was rarely controlled at all.--S. Kim
Pelvic Neuroblastoma:
A
Better
Prognosis.
S. Ghasali. Ann. Surg. 179:115, 1974.
Seven children with pelvic neuroblastoma between the ages of 2 wk and 1 yr 1 I m o at the time of diagnosis are described. In four of the
children, the presenting symptom was acute retention of urine and in the other three, the t u m o r was palpated at birth or soon after. No abnormality was detected on bone marrow examination in the two children who had this test performed. Skeletal survey and chest x-rays of all the children showed no distant metastases. The liver was not involved in any of the children. lilac lymph nodes were replaced by metastatic tumor in two children. Complete excision of the tumor was not possible in any of the seven children. Only a biopsy was performed in one child, and in two children a partial excision of t u m o r was performed on more than one occasion. All except one child were given vitamin BI~" for varying periods of time. One child was given radiotherapy 9 Histologic examination of the excised specimen showed it to be a cellular neuroblastoma with a high degree of malignancy in five children. Six children are alive after treatment and they are now 22, 20, 17, 16, 14, and 10 yr of age. One child died at the age of 3 yr 5 mo and autopsy confirmed that the t u m o r had undergone spontaneous regression. Death had occurred from intestinal obstruction subsequent to band adhesions from previous surgery. At present, the author does not recommend vitamin BI2 in the treatment of neuroblastoma. The better prognosis is considered to be due to the young age at the time of presentation and the site of the tumor. Frank G. DeLuca
Combined Radical Surgery, Radiation Therapy, and Chemotherapy in Infants With Vulvavaginal Embryonal Rhabdomyosarcoma. M. S. Piver, J. J. Barlow, J. K, Wang, and N. K. Shah. Obstet. Gynecol. 42:522-526 (October), 1973.
Three short-term follow ups of patients at ages 10, 11, and 15 mo with vaginal rhabdomyosarcoma are presented. The first child presented with a labial lesion and underwent radical vulvectomy and bilateral inguinal lymphadenectomy, followed by radiation therapy, actinomycin D, and vincristine. The patient is now 21 mo without disease. The second patient underwent total pelvic exenteration, radiotherapy, vincristine, and cyclophosphamide for a vaginal lesion and is 8 mo without disease. The third child underwent vaginectomy and a modified radical hysterectomy, radiation therapy, actinomycin D, and vincristine. That patient is now 5 mo without disease9 The authors feel that triple therapy is the treatment of choice. S . Kim