Management of nephroblastoma in childhood. Clinical study of two forms for maintenance chemotherapy. Medical Research Council's Working Party on embryonal tumours in childhood

Abstract

This report presents results of the first multicentre study of the treatment of nephroblastoma in the United Kingdom. Of 114 children entered in the trial, 108 with localised tumours and without identified metastases were treated by nephrectomy and a 4-day course of actinomycin D, followed by radiotherapy: they were then allocated randomly either to receive further courses of actinomycin D or to receive vincristine for a period of 2 years from diagnosis. The children have so far been followed for periods of between 27 and 69 months; at this stage the superiority of vincristine (in the dose given) to further actinomycin D in preventing local recurrence and metastasis borders on significance; the difference between survival rates also suggests an advantage for vincristine but is not statistically significant. The actuarial survival and continuous disease-free rates at 2 years were 77·7% and 53·6% respectively in the actinomycin D group compared with 87·8% and 79·4% in the vincristine group.