Journal
PEDIATRIC BLOOD & CANCER
Volume 65, Issue 8, Pages -Publisher
WILEY
DOI: 10.1002/pbc.27085
Keywords
boost; intermediate risk; lymph node; radiotherapy; Wilms tumour
Categories
Funding
- Cancer Research UK [C1188/A8687]
- UK National Cancer Research Network and Children's Cancer and Leukaemia Group (CCLG)
- Societe Francaise des Cancers de l'Enfant and Association Leon Berard Enfant Cancereux and Enfant et Sante
- Gesellschaft fur Padiatrische Onkologie und Hamatologie
- Grupo Cooperativo Brasileiro para o Tratamento do Tumor de Wilms
- Sociedade Brasileira de Oncologia Pediatrica
- Spanish Society of Pediatric Haematology and Oncology
- Spanish Association Against Cancer
- National Institute for Health Research Biomedical Research Centre Funding Scheme
- SIOP-NL
- Deutsche Krebschilfe [50-2709-Gr2]
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ObjectiveTo evaluate the value of radiotherapy boost omission in patients with intermediate-risk, stage III Wilms tumours (WT) with positive lymph nodes (LN). Methods and materialsAll patients with intermediate-risk, stage III (LN positive) WT consecutively registered in the SIOP-WT-2001 study were included in this analysis. Endpoints were 5-year event-free survival (EFS), loco-regional control (LRC) and overall survival (OS). ResultsBetween June 2001 and May 2015, 2,569 patients with stage I to III WT after preoperative chemotherapy were registered in the SIOP-WT-2001 study. Five hundred and twenty-three (20%) had stage III disease, of which 113 patients had stage III due to positive LN only. Of those, 101 (89%) received radiotherapy, 36 of which (36%) received, apart from flank irradiation, a boost dose to the LN positive area. Four patients (4%) did not receive any adjuvant radiotherapy. In eight patients information on radiotherapy was not available. With a median follow-up of 71 months, no difference in 5-year EFS (84%vs. 83%, P=0.77) and LRC (96%vs. 97%, P=0.91) was observed between patients receiving a radiotherapy boost and those without boost, respectively. Five-year OS, including salvage therapy, was excellent (boost vs. no boost: 97%vs. 95%, P=0.58). ConclusionsOutcome data demonstrate that omission of the radiotherapy boost to the loco-regional positive lymph nodes in patients with intermediate-risk, stage III WT who receive preoperative chemotherapy and postoperative flank irradiation (14.4Gy) can be considered a safe approach for future SIOP protocols.
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