- 作者：John A. Kalapurakal ; MD&lowast ; ; j-kalapurakal@northwestern.edu ; Elizabeth J. Perlman ; MD&lowast ; ; Nita L. Seibel ; MD&dagger ; ; Michael Ritchey ; MD&Dagger ; ; Jeffrey S. Dome ; MD ; PhD§ ; ; Paul E. Grundy ; MD¡¬
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2013
- 出版时间：1 February, 2013
- 年：2013
- 卷：85
- 期：2
- 页码：428-431
- 全文大小：151 K
Purpose
To report the clinical outcomes of children with revised stage I clear cell sarcoma of the kidney (CCSK) using the National Wilms Tumor Study Group (NWTS)-5 staging criteria after multimodality treatment on NWTS 1-5 protocols.Methods and Materials
All CCSK patients enrolled in the National Wilms Tumor Study Group protocols had their pathology slides reviewed, and only those determined to have revised stage I tumors according to the NWTS-5 staging criteria were included in the present analysis. All patients were treated with multimodality therapy according to the NWTS 1-5 protocols.
Results
A total of 53 children were identified as having stage I CCSK. All patients underwent primary surgery with radical nephrectomy. The chemotherapy regimens used were as follows: regimen A, C, F, or EE in 4 children (8 % ); regimen DD or DD4A in 33 children (62 % ); regimen J in 4 children (8 % ); and regimen I in 12 children (22 % ). Forty-six patients (87 % ) received flank radiation therapy (RT). Seven children (13 % ) did not receive flank RT. The median delay between surgery and the initiation of RT was 9 days (range, 3-61). The median RT dose was 10.8 Gy (range, 10-36). The flank RT doses were as follows: 10.5 or 10.8 Gy in 25 patients (47 % ), 11-19.9 Gy in 2 patients (4 % ), 20-29.9 Gy in 9 patients (17 % ), and 30-40 Gy in 10 patients (19 % ). The median follow-up for the entire group was 17 years (range, 2-36). The relapse-free and cancer-specific survival rate was 100 % at the last follow-up examination.
Conclusions
The present results have demonstrated that children with revised stage I CCSK using the NWTS-5 staging criteria have excellent survival rates despite the use of varying RT doses and chemotherapy regimens in the NWTS 1-5 protocols.