NATIONAL WILMS' TUMOR STUDY

现代治疗方法极大地提高了患者的存活率 患有肾母细胞瘤的儿童。手术、放射治疗、 现在，化疗治愈了85%以上的患者。然而，前景是 对于那些组织学不佳的人来说很差，那里的两年存活率较低 超过30%；以及那些在确诊时有任何组织学和转移的人(约 50%的存活率)。治疗这些患者的更有效的方法必须是 发展起来的。同时，所有的治疗都有其风险和并发症， 对于那些预后良好的患者，需要改进治疗，以便 以最低的发病率实现最大的存活率。NWTS-3是在第一个基础上建立的 两个研究并使用了从那里开发的分期系统。这些问题 被问到的问题是：(1)10周的AMD和VCR维持治疗是否足够 第一阶段？(2)第二阶段是否需要RT？(3)1000rad是否足够 III期的治疗？(4)环磷酰胺对IV期和 不利的组织学？(5)成功治疗的晚期不利因素是什么？ 在NWTS患者中？(6)阿霉素，一种心脏毒素可以从 组织学好的II、III期的治疗？

Modern treatment methods have led to a major improvement in the survival rate of children with Wilms' tumor. Combined therapy using surgery, radiation therapy, and chemotherapy now cures more than 85% of patients. However, the outlook is poor for those with unfavorable histology, where the 2 year survival is less than 30%; and for those with any histology and metastases at diagnosis (about 50% survival). More effective means of treating these patients must be developed. At the same time, all treatments have their risk and complications, and refinements of therapy for those with a good prognosis are needed so as to achieve maximum survival with the least morbidity. NWTS-3 is built on the first two studies and uses the staging systems developed therefrom. The questions being asked are: (1) Is 10 weeks of AMD and VCR maintenance therapy enough for Stage I? (2) Is RT needed for Stage II? (3) Does 1000 rad suffice for the treatment of Stage III? (4) Will cyclophosphamide be of value for Stage IV and unfavorable histology? (5) What are the late adversities of successful treatment in NWTS patients? (6) Can adriamycin, a cardio-toxin be eliminated from the treatment of favorable histology Stages II and III?