World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website http://www.wjon.org

Original Article

Volume 6, Number 5, October 2015, pages 441-445

Initial Surgery in Tailoring Treatment for Children With Stage II and III Wilms’ Tumor: An Experience From Resource Challenged Settings

Figure

Figure 1.
Figure 1. CT image showing a left renal mass with enhancing renal parenchyma posteriorly. Lobulated tumor thrombus is present in the left renal vein and IVC.

Tables

Table 1. Chemotherapeutic Agents Used for WT Treatment
 
Drug namePediatric dose
Dactinomycin0.015 mg/kg IV push qd for 5 days
Vincristine1.5 mg/m2 IV q1-3 weeks, not to exceed 2 mg/dose
Cyclophosphomide1.2 - 2.2 g/m2 IV qd for 1 - 3 days
Etoposide100 mg/m2 IV qd for 5 days
Doxorubicin (adriamycin)45 mg/m2 IV

 

Table 2. Chemotherapeutic Regimens in Relation to the Stage of WT
 
StageChemotherapeutic regimen
FH: favorable histology; AMD: dactinomycin; VCR: vincristine; DOX: doxorubicin; CPM: cyclophosphamide: E: etoposide.
Stage II (FH), stage III (FH)DD-4A (AMD, VCR, and DOX; 24 weeks
Stage II or stage III (focal or diffuse anaplasia)I (VCR + CPM + E; 24 weeks)

 

Table 3. Comparative Relapse Rate Between Groups I and II
 
RelapseGroup IGroup IIP value
Stage II3 (20%)0< 0.02
Stage III2 (13.3%)1< 0.04

 

Table 4. Complications of Chemotherapy Among the Studied Patients
 
ComplicationNumber of patients
Bone marrow depression9 (30%)
Bowel obstruction4 (13.3%)
Hepatic dysfunction6 (20%)
Interstitial pneumonitis2 (6.7%)
Cardiomyopathy1 (3.3%)