Comparison between single-dose and divided-dose administration of dactinomycin and doxorubicin for patients with Wilms' tumor: a report from the National Wilms' Tumor Study Group - PubMed
Clinical Trial
doi: 10.1200/JCO.1998.16.1.237.
N E Breslow, J B Beckwith, J Z Finklestein, P E Grundy, P R Thomas, T Kim, S J Shochat, G M Haase, M L Ritchey, P P Kelalis, G J D'Angio
Affiliations
- PMID: 9440748
- DOI: 10.1200/JCO.1998.16.1.237
Clinical Trial
Comparison between single-dose and divided-dose administration of dactinomycin and doxorubicin for patients with Wilms' tumor: a report from the National Wilms' Tumor Study Group
D M Green et al. J Clin Oncol. 1998 Jan.
Abstract
Purpose: The National Wilms' Tumor Study (NWTS)-4 was designed to evaluate the efficacy, toxicity, and cost of administration of different regimens for the treatment of Wilms' tumor (WT).
Patients and methods: Between August 6, 1986 and September 1, 1994, 1,687 previously untreated children less than 16 years of age with stages I to II/favorable histology (FH) or stage I/anaplastic histology WT (low-risk [LR] group) or stages III to IV/FH WT or stages I to IV/clear cell sarcoma of the kidney (high-risk [HR] group) were randomized to treatment that included vincristine and either divided-dose (standard [STD]) courses (5 days) or single-dose (pulse-intensive [PI]) treatment with dactinomycin. HR patients also received either STD courses (3 days) or PI treatment with doxorubicin.
Results: The 2-year relapse-free survival (RFS) rates for LR patients were 91.3% for 544 randomized to treatment with PI and 91.4% for 556 randomized to treatment with STD chemotherapy (P = .988). The 2-year RFS rates for HR patients were 87.3% for 299 randomized to treatment with PI and 90.0% for 288 randomized to treatment with STD chemotherapy (P = .865).
Conclusion: We conclude that patients treated with PI combination chemotherapy for LR or HR WT or clear cell sarcoma of the kidney have equivalent 2-year RFS to those treated with STD regimens. PI drug administration is recommended as the new standard based on demonstrated efficacy, greater administered dose-intensity, less severe hematologic toxicity, and the requirement for fewer physician and hospital encounters.
Similar articles
-
Green DM, Breslow NE, Beckwith JB, Finklestein JZ, Grundy P, Thomas PR, Kim T, Shochat S, Haase G, Ritchey M, Kelalis P, D'Angio GJ. Green DM, et al. J Clin Oncol. 1998 Dec;16(12):3744-51. doi: 10.1200/JCO.1998.16.12.3744. J Clin Oncol. 1998. PMID: 9850017 Clinical Trial.
-
Green DM, Beckwith JB, Breslow NE, Faria P, Moksness J, Finklestein JZ, Grundy P, Thomas PR, Kim T, Shochat S, et al. Green DM, et al. J Clin Oncol. 1994 Oct;12(10):2126-31. doi: 10.1200/JCO.1994.12.10.2126. J Clin Oncol. 1994. PMID: 7931483 Clinical Trial.
-
Seibel NL, Li S, Breslow NE, Beckwith JB, Green DM, Haase GM, Ritchey ML, Thomas PR, Grundy PE, Finklestein JZ, Kim T, Shochat SJ, Kelalis PP, D'Angio GJ. Seibel NL, et al. J Clin Oncol. 2004 Feb 1;22(3):468-73. doi: 10.1200/JCO.2004.06.058. J Clin Oncol. 2004. PMID: 14752069 Clinical Trial.
-
Treatment of Wilms' tumour. Current recommendations.
Mehta MP, Bastin KT, Wiersma SR. Mehta MP, et al. Drugs. 1991 Nov;42(5):766-80. doi: 10.2165/00003495-199142050-00004. Drugs. 1991. PMID: 1723373 Review.
-
Wu HY, Snyder HM 3rd, D'Angio GJ. Wu HY, et al. Curr Opin Urol. 2005 Jul;15(4):273-6. doi: 10.1097/01.mou.0000172403.69890.eb. Curr Opin Urol. 2005. PMID: 15928519 Review.
Cited by
-
Daw NC, Chi YY, Kim Y, Mullen EA, Kalapurakal JA, Tian J, Khanna G, Geller JI, Perlman EJ, Ehrlich PF, Warwick AB, Grundy PE, Fernandez CV, Dome JS; AREN0321 Study Committee. Daw NC, et al. Eur J Cancer. 2019 Sep;118:58-66. doi: 10.1016/j.ejca.2019.05.033. Epub 2019 Jul 17. Eur J Cancer. 2019. PMID: 31325873 Free PMC article.
-
Apoptotic protein expression in favorable-histology Wilms tumor correlates with tumor recurrence.
Agarwal S, Iyer VK, Agarwala S, Mathur SR, Aron M, Datta Gupta S, Verma K. Agarwal S, et al. Pediatr Surg Int. 2011 Mar;27(3):303-8. doi: 10.1007/s00383-010-2740-0. Epub 2010 Oct 21. Pediatr Surg Int. 2011. PMID: 20963425
-
Optimal sampling for design-based estimators of regression models.
Chen T, Lumley T. Chen T, et al. Stat Med. 2022 Apr 15;41(8):1482-1497. doi: 10.1002/sim.9300. Epub 2022 Jan 6. Stat Med. 2022. PMID: 34989429 Free PMC article.
-
Langholz B, Skolnik JM, Barrett JS, Renbarger J, Seibel NL, Zajicek A, Arndt CA. Langholz B, et al. Pediatr Blood Cancer. 2011 Aug;57(2):252-7. doi: 10.1002/pbc.22882. Epub 2010 Dec 1. Pediatr Blood Cancer. 2011. PMID: 21671362 Free PMC article.
-
Davidoff AM. Davidoff AM. Curr Opin Pediatr. 2009 Jun;21(3):357-64. doi: 10.1097/MOP.0b013e32832b323a. Curr Opin Pediatr. 2009. PMID: 19417665 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous