NATIONAL WILMS' TUMOR STUDY-4

现代治疗方法已导致生存率的重大改善 Wilms' tumor（WT）的发病率。使用手术的联合治疗， 放射治疗和化学治疗现在治愈了90%的患者， 组织学WT。组织学不良的肾肿瘤患者，尤其是 那些有转移的，无论是同步的还是异时的， 风险他们的存活率在50-65%之间，更好的治疗显然 是必要的。同时，所有疗法都有其相关的风险， 并发症，有些是昂贵的和沉重的医务人员， 家里对有良好前景的儿童进行治疗的改进包括： 因此，需要提高效率，降低风险和成本。NWTS-4 旨在通过更好地了解 儿童肾肿瘤的流行病学和晚期效应 成功的治疗，同时进行新疗法的临床试验。 这些试验解决了以下问题： 在较短的时间内更频繁地给予有效的化疗药物， 间隔改善前景，同时降低成本和家庭压力？的 因此，NWTS承担了一项新的任务： 治疗的负担，同时继续争取更多的治疗，并继续 其对肾母细胞瘤延迟后果的开创性研究 治疗。

Modern treatment methods have led to major improvements in the survival rate of children with Wilms' tumor (WT). Combined therapy using surgery, radiation therapy and chemotherapy now cures 90% of patients with favorable histology WT. Those with renal tumors of unfavorable histology, especially those with metastases, either synchronous or metachronous, are at higher risk. Their survival is in the 50-65% range, and better treatments clearly are needed. At the same time, all therapies have their associated risks and complications, and some are costly and burdensome for the medical staff and the family. Refinements of therapy for children with a good outlook are therefore needed to increase efficiency, and reduce risks and costs. NWTS-4 is designed to achieve these objectives through better understanding of the renal tumors of childhood, their epidemiology and the late effects of successful therapy, while conducting clinical trials of novel therapies. These trials address the following question: Can single daily doses of effective chemotherapeutic agents given more frequently over a shorter interval improve the outlook while decreasing costs and family stress? The NWTS thus has undertaken a new task: the reduction of the socioeconomic burdens of therapy while continuing to strive for more cures and continuing its pioneering studies of the delayed consequences of Wilms' tumor treatments.