Effect of duration of treatment on treatment outcome and cost of treatment for Wilms' tumor: a report from the National Wilms' Tumor Study Group
| Autor: | P. R.M. Thomas, G J D'Angio, G. M. Haase, Daniel M. Green, P. E. Grundy, P Kelalis, S Shochat, J Z Finklestein, Norman E. Breslow, T Kim, M. L. Ritchey, J. B. Beckwith |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Cancer Research Vincristine medicine.medical_specialty Randomization Time Factors Adolescent medicine.medical_treatment Cost-Benefit Analysis Episode of Care Urology Wilms Tumor Drug Administration Schedule law.invention Randomized controlled trial law Antineoplastic Combined Chemotherapy Protocols medicine Humans Child Survival analysis Neoplasm Staging Chemotherapy Antibiotics Antineoplastic business.industry Infant Wilms' tumor Health Care Costs Neoplasms Germ Cell and Embryonal medicine.disease Antineoplastic Agents Phytogenic Survival Analysis Kidney Neoplasms United States Surgery Treatment Outcome Oncology Doxorubicin Child Preschool Dactinomycin Female Sarcoma business Kidney disease medicine.drug |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 16(12) |
| ISSN: | 0732-183X |
| Popis: | PURPOSE National Wilms' Tumor Study (NWTS)-4 was designed to evaluate the efficacy, toxicity, and cost of the administration of different regimens for the treatment of Wilms' tumor (WT). PATIENTS AND METHODS Between August 6, 1986 and September 1, 1994, 905 previously untreated children aged younger than 16 years with stage II favorable histology (FH) WT (low-risk [LR]), stages III to IV FH WT, or stages I to IV clear-cell sarcoma of the kidney (high-risk[HR]) were randomized after the completion of 6 months of chemotherapy to discontinue (short) or continue for 9 additional months (long) treatment with chemotherapy regimens that included vincristine and either divided-dose (standard [STD]) courses (5 days) or single-dose (pulse-intensive [PI]) treatment with dactinomycin. HR patients also received either divided-dose (STD) courses (3 days) or single-dose (PI) treatment with doxorubicin. RESULTS The 4-year relapse-free survival (RFS) rates after the second randomization for LR patients were 83.7% for the 190 patients treated with short and 88.2% for the 187 patients treated with long chemotherapy (P = .11). The 4-year RFS rates after the second randomization for HR FH patients were 89.7% for the 256 patients treated with short and 88.8% for the 246 patients treated with long chemotherapy (P = .87). The charge for treatment with the short PI treatment regimens for all children with stages I through IV FH WT was approximately one half of that with the long STD treatment regimens. CONCLUSION The short administration schedule for the treatment of children with WT is no less effective than the long administration schedule and can be administered at a substantially lower total treatment cost. |
| Databáze: | OpenAIRE |
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