肾母细胞瘤：放线菌素D与长春新碱辅助治疗
Wilms' tumour: adjuvant treatment with actinomycin D and vincristine.
作者信息
Jenkin R D, Jeffs R D, Stephens C A, Sonley M J
出版信息
Can Med Assoc J. 1976 Jul 17;115(2):136-40.
In an unselected series of 49 children with Wilms' tumour treated in 1969-74 the 5-year relapse-free survival and survival rates were 78% and 81%, respectively, whereas in the series of children treated in 1963-68 the corresponding rates were 49% and 70%. The significant improvement in the relapse-free survival rate was a result of adjuvant treatment with actinomycin D and vincristine (AMD + VCR), which, in some patients, eradicated occult metastatic disease. In the treatment of lung metastases the combination of whole-lung irradiation and maintained chemotherapy with AMD + VCR proved excessively toxic: in 5 of 11 patients acute diffuse pneumonitis developed, and it was fatal in 3. Adjuvant AMD + VCR therapy is advocated in all patients with Wilms' tumour except children less than 12 months old with a tumour of moderate size, limited to the kidney and completely resectable.
在1969年至1974年接受治疗的未经挑选的49例威尔姆斯瘤患儿中，5年无复发生存率和生存率分别为78%和81%，而在1963年至1968年接受治疗的患儿系列中，相应的比率分别为49%和70%。无复发生存率的显著提高是放线菌素D和长春新碱辅助治疗（AMD + VCR）的结果，在一些患者中，这种治疗根除了隐匿性转移性疾病。在肺转移瘤的治疗中，全肺照射与AMD + VCR维持化疗相结合被证明毒性过大：11例患者中有5例发生急性弥漫性肺炎，其中3例死亡。除12个月以下、肿瘤大小适中、局限于肾脏且可完全切除的患儿外，所有威尔姆斯瘤患者均提倡采用AMD + VCR辅助治疗。
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