Treatment of relapsed Wilms tumors: lessons learned
Year: 2009
Type: review
Abstract: Treatment regimens for recurrent Wilms tumor (WT) are currently designed to include drugs that are not used during primary chemotherapy, using a risk-stratified approach. Therapy of recurrent disease depends on the nature of initial treatment, and of recognized prognostic indicators inherent in the primary tumor. Several highly effective chemotherapy regimens, including ifosfamide-carboplatin-etoposide, cyclophosphamide-etoposide and carboplatin-etoposide, are considered first treatment choice for recurrent disease. While intense-dose chemotherapy is uniformly accepted to treat high-risk recurrent WTs, the optimal therapy for standard-risk children has yet to be defined, owing to the small number of such patients and their relatively better prognosis compared with high-risk recurrences. Recurrent tumors among those defined as very-high risk are likely to develop chemoresistant disease, and novel therapeutic strategies will be necessary to cure these patients. Evidence on how to properly administer surgery and radiotherapy at relapse is more fragmentary. The authors have reviewed the available experiences concerning the treatment of recurrent WT, and have attempted to provide the most up-to-date recommendations regarding the optimal risk-based treatment for these patients.
DOI: 10.1586/era.09.159
Institutions: Fondazione IRCCS Istituto Nazionale dei Tumori, Institute of Cancer Research, Royal Marsden Hospital, Children's Hospital Los Angeles, Institut d’Hématologie et d’Oncologie Pédiatrique, Centre Léon Bérard, Newcastle University, Emma Kinderziekenhuis, Istituto Giannina Gaslini, Hospital Materno-Infantil, Children's National
Language: English
Topic: Renal and related cancers
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2158653287