NATIONAL WILMS' TUMOR STUDY - 4

现代治疗方法极大地提高了患者的存活率。 儿童肾母细胞瘤的发生率。通过手术进行综合治疗， 放射治疗和化疗现在治愈了90%的患者。那些拥有 组织学不良的肿瘤和有转移的肿瘤 同步或异时，风险更高。他们的生存取决于 50%-65%，显然需要更好的治疗。同时， 所有的疗法都有其相关的风险和并发症，有些是 既昂贵又不方便。改善治疗对儿童的良好影响 因此，需要展望以提高效率，降低风险和 成本。NWTS-4旨在通过更好的 对儿童肾肿瘤的认识、流行病学及临床意义 成功治疗的远期效应，同时进行临床试验 新奇的疗法。后者提出了以下问题：(1)是否可以单独 更频繁地给予有效化疗药物的日剂量 更短的间隔改善了前景，同时降低了成本和 不方便？(2)这种结合新药的疗法能改善 复发性疾病患者的检索率，并在这样做时 为初级保健确定新的代理？因此，NWTS正在进行新的 任务：确定新的有效化疗方法；以及 在争取更多治疗的同时减少治疗的社会经济负担 治愈。

Modern treatment methods have led to major improvements in the survival rate of children with Wilms' tumor. Combined therapy using surgery, radiation therapy and chemotherapy now cures 90% of patients. Those with tumors of unfavorable histology and 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 inconvenient. 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 latter ask the following questions: (1) Can single daily doses of effective chemotherapeutic agents given more frequently over a shorter interval improve the outlook while decreasing costs and inconvenience? (2) Can such regimens incorporating new drugs improve the retrieval rate for patients with recurrent disease, and in so doing identify new agents for primary care? The NWTS thus is undertaking new tasks: the identification of new, effective chemotherapies; and the reduction of the socio-economic burdens of therapy while striving for more cures.