NATIONAL WILMS' TUMOR STUDY

现代治疗方法已导致生存率的重大改善， 患有肾母细胞瘤的孩子 使用手术，放射治疗， 化疗治愈了85%以上的病人 然而，前景是 对于组织学不良的患者，2年生存率较低， 超过30%;对于诊断时有任何组织学和转移的患者（约 50%存活率）。 必须采取更有效的方法来治疗这些患者， 开发 同时，所有的治疗都有风险和并发症， 需要对那些预后良好的患者进行治疗， 以最小的发病率获得最大的生存率。 NWTS-3是建立在第一个 两个研究和使用由此开发的分级系统。 的问题 被问到的问题是：（1）10周的AMD和VCR维持治疗是否足以 第一阶段？ (2)第二阶段是否需要RT？ (3)1000拉德足够吗 第三阶段的治疗？ (4)环磷酰胺是否对IV期有价值， 不良组织学？(5)成功治疗的晚期逆境有哪些 在NWTS患者中？ (6)阿霉素，一种心脏毒素，能从 组织学良好的治疗II期和III期？

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?