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Treatment of Wilms ' tumor . Results of the Third National Wilms ' Tumor Study . The Third National Wilms ' Tumor Study sought to reduce treatment for low-risk patients and find better chemotherapy for those at high risk for relapse . Eligible patients ( 1439 ) were randomized according to stage ( I-IV ) and histology ( favorable [ FH ] or unfavorable [ UH ] ) , and contributed data to survival and relapse-free survival ( RFS ) analyses . Four-year ( postnephrectomy ) survival percentages and randomized treatment regimens for low-risk patients were 96.5 % for 607 Stage I/FH patients who received dactinomycin ( Actinomycin D [ AMD ] , Merck Sharp & Dohme , West Point , PA ) and vincristine ( VCR ) for 10 weeks versus 6 months ; 92.2 % for 278 Stage II/FH patients ; and 86.9 % for 275 Stage III/FH patients who received AMD + VCR +/- Adriamycin ( ADR , Adria Laboratories , Columbus , OH ) for 15 months . Stage II/FH patients also had either zero or 2000 cGy irradiation ( RT ) postoperatively and Stage III/FH patients either 1000 or 2000 cGy . Four-year survival was 73.0 % for 279 high-risk patients ( any Stage IV , all UH ) who received postoperative radiation therapy ( RT ) and AMD + VCR + ADR +/- cyclophosphamide ( CPM ) . Statistical analysis of survival and RFS experience shows that the less intensive therapy does not worsen results for low-risk patients and CPM does not benefit those at high risk .
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Intervention_Pharmacological
chemotherapy
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Intervention_Pharmacological
dactinomycin ( Actinomycin D [ AMD ]
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Intervention_Pharmacological
vincristine ( VCR )
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Intervention_Pharmacological
AMD + VCR +/- Adriamycin ( ADR
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Intervention_Pharmacological
postoperative radiation therapy ( RT )
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Intervention_Pharmacological
AMD + VCR + ADR +/- cyclophosphamide ( CPM )
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Intervention_Pharmacological
CPM
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Outcome_Mortality
Four-year survival
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Outcome_Mortality
survival
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Outcome_Mortality
RFS experience shows
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Participant_Condition
Wilms ' tumor .
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Participant_Condition
Wilms ' Tumor
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Participant_Sample-size
1439