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Second neoplasms after Wilms' tumor in childhood
Journal of the National Cancer Institute
|December 1, 1983
Summary
Wilms tumor survivors treated with radiotherapy have a significantly increased risk of developing second cancers, particularly solid tumors within the radiation field. Dactinomycin did not mitigate this risk.
Area of Science:
- Oncology
- Pediatric Oncology
- Cancer Epidemiology
Background:
- Wilms tumor is a common pediatric kidney cancer.
- Long-term survival rates for Wilms tumor have improved significantly.
- Understanding the risk of second neoplasms in survivors is crucial for long-term care.
Purpose of the Study:
- To investigate the frequency and types of second neoplasms in Wilms tumor patients.
- To assess the impact of radiotherapy on the development of second cancers.
- To evaluate the role of dactinomycin in radiation-associated second cancer risk.
Main Methods:
- Retrospective analysis of 487 Wilms tumor patients treated between 1927-1981.
- Detailed review of patient records for diagnosis and treatment of second primary tumors.
- Statistical analysis to determine cumulative probability and risk factors for second neoplasms.
Main Results:
- 30 patients (6%) developed second primary tumors, including 11 cancers.
- The cumulative probability of a second cancer after 34 years was 18%.
- All 11 second cancers occurred in patients who received radiotherapy, with 9 solid internal cancers arising within the radiation field (P < .001).
Conclusions:
- Radiotherapy for Wilms tumor significantly increases the risk of second solid cancers.
- The risk appears to be localized to the radiation field.
- Concurrent dactinomycin therapy did not reduce the risk of radiation-associated cancers.