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wilms radiotherapy pulmonary metastases

Basak Erginel, Feryal Gun Soysal, Erbug Keskin, Rejin Kebudi, Alaaddin Celik, Tansu Salman
BACKGROUND: This study aims to evaluate the outcomes of pulmonary metastasectomy resections in pediatric patients. METHODS: We retrospectively reviewed the medical records of 43 children who were operated on in the Pediatric Surgery Clinic between January 1988 and 2014. Forty-three children (26 boys; 17 girls; mean age 10±4.24 years, range 6 months-18 years) who underwent pulmonary metastasectomy resection were included in the study. The patients were evaluated based on age, gender, history of disease, surgical procedures, complications, duration of hospitalization, duration of chest tube placement, and procedure outcome...
2016: World Journal of Surgical Oncology
I R User, S Ekinci, G Kale, C Akyüz, M Büyükpamukçu, I Karnak, A Ö Çiftçi, F C Tanyel, M E Şenocak
INTRODUCTION: Outcomes of Wilms tumor improved in last 50 years and excellent survival rates can be achieved especially in case of non-metastatic disease and favorable histology. Nevertheless, bilateral cases still stand as a therapeutic challenge. Prognosis of bilateral Wilms tumor (BWT) is not as good as the unilateral tumors of similar stage and histology in terms of survival and renal function. OBJECTIVE: Management of BWT is constantly evolving and still stands as a therapeutic challenge...
June 2015: Journal of Pediatric Urology
Jane M Lange, Janice R Takashima, Susan M Peterson, John A Kalapurakal, Daniel M Green, Norman E Breslow
BACKGROUND: The standard treatment of pulmonary metastases in patients with Wilms tumor (WT) includes 12-gray radiotherapy (RT) to the entire chest. To the authors' knowledge, the risk of breast cancer (BC) in a large cohort of female survivors of WT has not previously been reported. METHODS: A total of 2492 female participants in National Wilms Tumor Studies 1 through 4 (1969-1995) were followed from age 15 years through the middle of 2013 for incident BC. The median age at the time of last contact was 27...
December 1, 2014: Cancer
Ahsan Farooqi, Arsalan Siddiqi, Mohammad K Khan, Natia Esiashvili
BACKGROUND: Most patients with stage IV Wilms tumor (WT) and pulmonary metastases are treated with surgery, local radiotherapy (RT), and whole-lung irradiation (WLI). The Children's Oncology Group is studying whether WLI should only be given if metastatic lung lesions persist following induction chemotherapy. We hypothesized that radiation dose to cardiac and pulmonary organs are increased when WLI and abdominal RT fields are administered sequentially. PROCEDURE: We retrospectively identified 16 patients with stage IV WT and pulmonary metastases to model dosimetry plans for concurrent and sequential flank or whole abdomen and whole-lung fields...
August 2014: Pediatric Blood & Cancer
Arnauld Verschuur, Harm Van Tinteren, Norbert Graf, Christophe Bergeron, Bengt Sandstedt, Jan de Kraker
PURPOSE: The purpose of this study was to determine the outcome of children with nephroblastoma and pulmonary metastases (PM) treated according to International Society of Pediatric Oncology (SIOP) 93-01 recommendations using pulmonary radiotherapy (RT) in selected patients. PATIENTS AND METHODS: Patients (6 months to 18 years) were treated with preoperative chemotherapy consisting of 6 weeks of vincristine, dactinomycin, and epirubicin or doxorubicin. If pulmonary complete remission (CR) was not obtained, metastasectomy was considered...
October 1, 2012: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Steven W Warmann, Rhoikos Furtwängler, Gunnar Blumenstock, Sorin Armeanu, Nasenien Nourkami, Ivo Leuschner, Jens P Schenk, Norbert Graf, Jörg Fuchs
OBJECTIVE: To analyze the outcome of Wilms' tumor patients with primary lung metastases. SUMMARY BACKGROUND DATA: Radiotherapy and/or surgery are used for local control of primary pulmonary Wilms' tumor metastases. A widely accepted treatment standardization is still lacking. METHODS: Data for 210 patients with Wilms' tumor and primary lung metastases from the collaborative multicenter trials SIOP 93-01/GPOH and SIOP 2001/GPOH of the German Society of Pediatric Oncology and Hematology were reviewed...
July 2011: Annals of Surgery
I Einarsson, T Gudbjartsson, G V Einarsson, J H Johannsson, G K Jonmundsson, G Bjarnason
OBJECTIVE: Wilms' tumor is a malignant disease in the kidneys that usually affects young children. Information about the clinical behaviour of this tumor in Iceland has been scarce. The aim of this study was to find the incidence, clinical presentation, treatment and survival of patients with Wilms' tumor. MATERIAL AND METHODS: Included in the study were all patients diagnosed with Wilms' tumor in Iceland from 1st of January 1961 to 31st of December 1995. Altogether, there were 17 patients, 15 children, mean age 33 months (standard deviation 19, range 5-77 months) and two adults (age 25 and 29), with M/F ratio 0...
February 1998: Læknablađiđ
Gary Nicolin, Roger Taylor, Chris Baughan, Rosemary Shannon, Suzanne Stevens, Donna Richardson, Anna Kelsey, Kathy Pritchard-Jones, Christopher Mitchell
PURPOSE: To evaluate the effect of whole lung radiotherapy on event-free and overall survival of children with Stage IV Wilms' tumor with pulmonary metastases at diagnosis and to ascertain factors that may have led to the decision to withhold radiotherapy. METHODS AND MATERIALS: We compared recurrence and mortality risks of patients with pulmonary metastases at diagnosis enrolled in the UKW2 and UKW3 clinical trials (1986-2001) according to treatment with pulmonary radiotherapy...
January 1, 2008: International Journal of Radiation Oncology, Biology, Physics
Peter F Ehrlich, Thomas E Hamilton, Paul Grundy, Michael Ritchey, Gerald Haase, Robert C Shamberger et al.
BACKGROUND/PURPOSE: Computed tomography (CT) of the chest with its increased sensitivity frequently identifies lesions not visible on chest radiograph. Treatment of such lesions is controversial. A recent review suggests that patients with Wilms' tumor with pulmonary lesions detected only by CT, who were treated with dactinomycin and vincristine, have an inferior outcome compared with those who also received pulmonary radiation therapy (RT) and doxorubicin. It is important to determine if these small lesions seen only on CT represent metastatic disease and whether patients with these lesions require RT and/or doxorubicin for optimal outcome...
January 2006: Journal of Pediatric Surgery
W Torre, N Rodriguez-Spiteri, L Sierrasesumaga
UNLABELLED: A retrospective review of surgical interventions for pulmonary metastases found 44 surgical metastasectomies in patients 20 years old or younger. OBJECTIVE: Indications for pulmonary metastasectomy are well established in adults, but are not so clear when we are dealing with a younger population. PATIENTS AND METHODS: A retrospective review of surgical interventions for pulmonary metastases (from December 1996 to October 2001) found 44 surgical metastasectomies in patients considered pediatric or young adults (20 years old or younger)...
April 2004: Thoracic and Cardiovascular Surgeon
E Costa Borrás, J Ferrís i Tortajada, C Jovaní Casano, V Segarra Llido, M Bermúdez Cortés, A Cañete Nieto, J Velázquez Terrón
OBJECTIVE: We comment and update the surgical treatment for pulmonary metastases (PM) within a multidisciplinary approach for paediatric cancer. MATERIAL AND METHODS: We analyse patients with PM who have been operated between 1976-1996. Scientific literature published in the last 25 years (Cancerlit and Medline) was reviewed. RESULTS: PM from 13 patients were removed. Seven were males and 6 females with a mean age 5 4/12 years (range: 11 months- 12 3/12 years)...
July 1998: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
I Karnak, M Emin Senocak, T Kutluk, F C Tanyel, N Büyükpamukçu
Pulmonary surgery is frequently used for the treatment of metastasis or nodules in children with various types of malignancies. However, the indications and effectiveness of pulmonary metastatectomy have not been evaluated recently. Therefore, a retrospective study was conducted to analyse the results of pulmonary metastatectomy in children. Children who underwent pulmonary metastatectomy at our department between 1990 and 2000 were reviewed. Eighteen children consisting of 11 boys and 7 girls (age range, 3 to 18 years) underwent thoracotomy for pulmonary metastasis excision...
June 2002: European Journal of Pediatric Surgery
G S Tomlinson, C H Cole, N M Smith
Bilateral Wilms' tumor occurs at a younger age than unilateral disease. While it generally has a good prognosis, it presents a therapeutic dilemma to balance curative surgical resection with preservation of renal tissue. A 15 year review of bilateral Wilms' tumors diagnosed at Princess Margaret Hospital was undertaken. Of 46 Wilms' tumor cases, eight were designated bilateral by diagnostic imaging (median age 1.1 years compared with 3.5 years for unilateral tumors). The surgical management entailed primary nephrectomy with contralateral biopsy in two patients, and bilateral biopsy and delayed resection in all remaining surviving patients (one patient died of perioperative complications)...
February 1999: Pathology
J Godzinski, M F Tournade, J De Kraker, R Ludwig, A Weirich, P A Voute, J M Burgers, J L Habrand, B Sandstedt, M Ducourtieux
Treatment of Wilms' tumor is an example of success of modern oncology. A combination of surgery, radiotherapy, and chemotherapy is widely accepted as the efficacious treatment of nephroblastoma. However, timing of each part of the treatment differs, in various protocols: the Societe Internationale d'Oncologie Pediatrique (SIOP) recommends the diagnosis based on imaging and metabolic exclusion of neuroblastoma to reduce the biopsy-related risk of spillage. In patients more than 6 months old, the treatment starts with the preoperative chemotherapy to improve the stage distribution at surgery and decrease the complications rate...
February 1999: Seminars in Urologic Oncology
U M Saarinen-Pihkala, S Wikström, K Vettenranta
In children with bilateral Wilms' tumor, the therapy should aim at maximal preservation of renal parenchyma and function. Local radiotherapy may give rise to second malignant neoplasms and may impair renal function. We present a therapeutic strategy without any irradiation. Three children were diagnosed with bilateral Wilms' tumor at ages from 6 months to 5 years. Each patient had a massive tumor with local stage III on one side; one had pulmonary metastases. The therapeutic strategy was first to obtain tissue for histology by percutaneous needle biopsy, to administer pre-operative chemotherapy until desired tumor shrinkage, and then to perform kidney-sparing resective surgery...
July 1998: Bone Marrow Transplantation
N Minkov, I Christosova, S Kiourktchieva, T Rousseva
88 children with primary renal tumours (85 with nephroblastoma and 3 with renal cell carcinoma) were treated between 1973 and 1990 in the paediatric urology department of Institute "Pirogov" and the paediatric haematological oncology department in Sofia. Combined therapy includes early surgery (nephrectomy + lymphadenectomy) and combination chemotherapy (Dactinomycin, Vincristine + Adriamycin, Endoxan). Stage II (with lymph node in involvement), III and IV disease was treated by radiotherapy. Chemotherapy and preoperative radiotherapy were administered in the case of very large tumours...
1997: Annales D'urologie
T E Merchant, M J Zelefsky, J M Sheldon, M B LaQuaglia, L B Harrison
BACKGROUND: Sixteen pediatric patients with solid tumors received treatment on a protocol designed to test the feasibility and safety of high-dose rate intraoperative radiation therapy (IOHDR) via a remote afterloader. PATIENTS AND METHODS: Patients with Ewing's sarcoma (n = 5), rhabdomyosarcoma (n = 3), synovial cell sarcoma (n = 2), Wilms tumor (n = 2), osteosarcoma, immature teratoma, desmoplastic small round cell tumor, and inflammatory fibrosclerosis were included...
January 1998: Medical and Pediatric Oncology
M Orditura, F De Vita, G Catalano
BACKGROUND: Wilms' tumor in an adult is rare and no treatment guidelines have been established, although all authors recommend aggressive therapy based on surgery, radiotherapy, and multiagent chemotherapy. METHODS: The authors describe a case of Wilms' tumor in a 23-year-old woman who developed hepatic and pulmonary metastases after undergoing nephrectomy. Treatment was initiated with carboplatin, etoposide, ifosfamide, and epirubicin combination chemotherapy and irradiation of the tumor bed, lungs, and liver...
November 15, 1997: Cancer
T A Seemayer, J L Harper, D Shickell, T G Gross
BACKGROUND: Complete maturation (cytodifferentiation) of treated metastatic Wilms' tumor is an infrequent occurrence. In a large series of reports, Wilms' metastases have generally contained malignant blastemic elements admixed with lesser amounts of cytodifferentiated mesenchyme. The authors describe a patient in whom complete maturation of a pulmonary metastasis was documented after intensive chemoradiotherapy. METHODS: A MEDLINE search was employed to identify pertinent cases from 1966 to the present...
April 15, 1997: Cancer
S Gururangan, J A Wilimas, B D Fletcher
Bone metastases are extremely rare in patients with classical Wilms' tumor (WT). We describe the clinical and radiologic features, treatment and outcome of three patients with WT (one with favorable histology and two with anaplasia) in whom bone metastases were detected at diagnosis or relapse. Bone metastases were documented by skeletal radiographs, computed tomography and/or bone scintigraphy. The patient with favorable histology WT had no evidence of pulmonary metastases and is now free of disease following aggressive chemotherapy and radiotherapy...
1994: Pediatric Radiology
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