Childhood cancer:The National Wilms' tumor study A progress report

Giulio J. D'Angio; J. Bruce Beckwith; Harry C. Bishop; Norman Breslow; Audrey E. Evans; Willard E. Goodwin; Lowell R. King; Lawrence K. Pickett; Lucius F. Sinks; Wataru W. Sutow; James A. Wolff

doi:10.1016/S0090-4295(74)80232-3

Childhood cancer:The National Wilms' tumor study A progress report

Giulio J. D'Angio, J. Bruce Beckwith, Harry C. Bishop, Norman Breslow, Audrey E. Evans, Willard E. Goodwin, Lowell R. King, Lawrence K. Pickett, Lucius F. Sinks, Wataru W. Sutow, James A. Wolff

Research output: Contribution to journal › Article › peer-review

Original language	English
Pages (from-to)	798-806
Number of pages	9
Journal	Urology
Volume	3
Issue number	6
DOIs	https://doi.org/10.1016/S0090-4295(74)80232-3
State	Published - Jun 1974
Externally published	Yes

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Urology

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@article{f53cb5621ff74f29b011a8dfbda8c50f,

title = "Childhood cancer:The National Wilms' tumor study A progress report",

author = "D'Angio, {Giulio J.} and {Bruce Beckwith}, J. and Bishop, {Harry C.} and Norman Breslow and Evans, {Audrey E.} and Goodwin, {Willard E.} and King, {Lowell R.} and Pickett, {Lawrence K.} and Sinks, {Lucius F.} and Sutow, {Wataru W.} and Wolff, {James A.}",

note = "Funding Information: Pediatric oncologists are therefore constantly faced with a therapeutic dilemma: is the risk of treatment and its immediate and late consequences warranted by the severity of the disease? ttefinement of therapy is one of the goals in pediatric oneology, tailoring the magnitude of the effort to the projected risk in the individual patient. {"}Routine{"} therapy-adding multiple agents and modalities to give the patient the {"}benefit of everything we have{"}-is not necessarily the best treatment. This has been recognized, of course, for some time. Schneider, in 1958, suggested that radiation therapy be withheld in patients with Wilms' tumor unless the renal pelvis, capsule, or regional lymph nodes were involvedF Pediatric surgeons, radiation therapists, and chemotherapists have been concerned about these questions for many years. Independent efforts, and those by national cooperative groups, have been made to resolve some of these problems. However, the number of patients with Wilms' tumor seen annually in the United States is perhaps 500, so that no one institution can expect to mount a study that will lead to results which are statistically meaningful. 6 Even the co-operative groups have difficulty in gathering enough patients who are managed according to age and stage so that a valid clinical trial can be completed in a reasonable length of time. Recognizing these limitations, the national cooperative study groups concerned with the management of children with solid tumors agreed to pool their patients and follow a common treatment protocol. The National Wilms' Tumor Study is the result of this notable display of cooperation in a common purpose. Certain independent institutions not already members of one of the national co-operative study groups have agreed to follow the study regimens, and have been enrolled in the Study. The aims of the investigation, which is supported by a grant from the National Institutes of Health, were defined as follows: {"}A. The primary objective of the Study is to refine methods of treatment. The elimination of unnecessary forms of therapy is always desirable. Thus, two specific questions are being asked: 1. Is postoperative radiotherapy necessary for the treatment of patients with well-encapsulated, localized lesions after what appears to be their total removal? Funding Information: '*Reprinted from the Seventh National Cancer Conference Proceedings, 1973, pages 626-636 (with permission of the American Cancer Society, Inc.). Supported in part by U.S. Public Health Service Grant R10 CA 11722.",

year = "1974",

month = jun,

doi = "10.1016/S0090-4295(74)80232-3",

language = "English",

volume = "3",

pages = "798--806",

journal = "Urology",

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TY - JOUR

T1 - Childhood cancer:The National Wilms' tumor study A progress report

AU - D'Angio, Giulio J.

AU - Bruce Beckwith, J.

AU - Bishop, Harry C.

AU - Breslow, Norman

AU - Evans, Audrey E.

AU - Goodwin, Willard E.

AU - King, Lowell R.

AU - Pickett, Lawrence K.

AU - Sinks, Lucius F.

AU - Sutow, Wataru W.

AU - Wolff, James A.

N1 - Funding Information: Pediatric oncologists are therefore constantly faced with a therapeutic dilemma: is the risk of treatment and its immediate and late consequences warranted by the severity of the disease? ttefinement of therapy is one of the goals in pediatric oneology, tailoring the magnitude of the effort to the projected risk in the individual patient. "Routine" therapy-adding multiple agents and modalities to give the patient the "benefit of everything we have"-is not necessarily the best treatment. This has been recognized, of course, for some time. Schneider, in 1958, suggested that radiation therapy be withheld in patients with Wilms' tumor unless the renal pelvis, capsule, or regional lymph nodes were involvedF Pediatric surgeons, radiation therapists, and chemotherapists have been concerned about these questions for many years. Independent efforts, and those by national cooperative groups, have been made to resolve some of these problems. However, the number of patients with Wilms' tumor seen annually in the United States is perhaps 500, so that no one institution can expect to mount a study that will lead to results which are statistically meaningful. 6 Even the co-operative groups have difficulty in gathering enough patients who are managed according to age and stage so that a valid clinical trial can be completed in a reasonable length of time. Recognizing these limitations, the national cooperative study groups concerned with the management of children with solid tumors agreed to pool their patients and follow a common treatment protocol. The National Wilms' Tumor Study is the result of this notable display of cooperation in a common purpose. Certain independent institutions not already members of one of the national co-operative study groups have agreed to follow the study regimens, and have been enrolled in the Study. The aims of the investigation, which is supported by a grant from the National Institutes of Health, were defined as follows: "A. The primary objective of the Study is to refine methods of treatment. The elimination of unnecessary forms of therapy is always desirable. Thus, two specific questions are being asked: 1. Is postoperative radiotherapy necessary for the treatment of patients with well-encapsulated, localized lesions after what appears to be their total removal? Funding Information: '*Reprinted from the Seventh National Cancer Conference Proceedings, 1973, pages 626-636 (with permission of the American Cancer Society, Inc.). Supported in part by U.S. Public Health Service Grant R10 CA 11722.

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Childhood cancer:The National Wilms' tumor study A progress report

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