The management of Wilms' tumour
This report is based essentially on 45 patients with Wilms' tumour treated during the period 1951 - 1967 with comments on a modified regime in 20 patients treated since 1968.
During the period 1951 - 1967 the standard treatment was nephrectomy and radiotherapy; cy:oxics were added from 1959. The over-all long-term survival was 42%, but all infants under the age of 1 Year have survived. Cytoxics increased the over-all survival rate from 19% to 55%. Although we aimed at giving post-operative irradiation only, 10 patients received pre-operarve therapy because of the enormous size of their tumours and/or malnutrition. Eight of these patients have survived.
In view of the above, all patients, excepting infants under 1 year, have received pre- and postoperative X-ray therapy since 1968. We have also modified the cytoxic regime and all patients have been given repeated courses of actinomycin 0, while those with metastases or recurrence have also received vincristine. The over-all survival rate to date is 60%.