NATIONAL WILMS' TUMOR STUDY - 4

现代治疗方法已导致生存率的重大改善 儿童Wilms' tumor的发病率 使用手术的联合治疗， 放射疗法和化学疗法现在治愈了90%的病人。 的人 组织学不良的肿瘤和转移瘤， 同步或异时的，都有更高的风险。 他们的生存在于 50-65%的范围，显然需要更好的治疗。 与此同时， 所有疗法都有其相关的风险和并发症，有些是 昂贵和不方便。 治疗的细化为儿童与良好的 因此，需要展望未来，以提高效率，降低风险， 成本 NWTS-4旨在通过更好地 了解儿童肾肿瘤，其流行病学和 成功治疗的晚期效应，同时进行临床试验， 新疗法 这些后者提出了以下问题：（1）可以单身吗 每日剂量的有效化疗剂给予更频繁， 较短的间隔改善前景，同时降低成本， 不方便吗 (2)这种包含新药的方案能否改善 复发性疾病患者的检索率，并在此过程中 为初级保健确定新的代理人？ 因此，NWTS正在进行新的 任务：确定新的、有效的化学疗法; 减少治疗的社会经济负担，同时争取更多的 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.