Rücker J, Engels M
Padiatr Padol. 1979;14(1):29-36.
On the second place in malignant diseases of children, after the leukemias, we could find the Wilms-Tumor. Of the 16 children we treated in the years from 1965 to 1977, 8 children died, 2 patients couldn't be any longer observed and 6 patients are still alive. 5 children of these have obtained now a relapse-free survival from 1 year and 2 months to 2 years and 7 months. We could see, that the prognosis depends only on the stage of the tumor and not on the age of patients. On 3 cases we will try to show, how difficult the diagnosis of the Wilms-Tumor is and how important it is, to treat resolutely pulmonary and liver metastases. As diagnostic methods were used i. v. P., the sonography and the selective renalangiography. Since 1976 our treatment consists of preoperative irradiation of tumors, nephrectomy, postoperative irradiation of tumor-bed and adjuvant chemotherapy (actinomycin D, vincristine and adriamycin). Pulmonary and liver metastases are a domain for chemotherapy, combined with irradiation (danger of pneumonitis and toxic hepatitis) and eventually a resection is necessary. Only the good cooperation of an oncologic team could achieve an improvement of the cure rate of this tumor, as we know from the American countries (survival 75%).
在儿童恶性疾病中，仅次于白血病的是肾母细胞瘤。在1965年至1977年期间我们治疗的16名儿童中，8名儿童死亡，2名患者无法再进行观察，6名患者仍然存活。其中5名儿童现已获得1年2个月至2年7个月的无复发生存期。我们可以看到，预后仅取决于肿瘤的分期，而不取决于患者的年龄。我们将通过3个病例来说明肾母细胞瘤的诊断有多困难，以及坚决治疗肺和肝转移灶有多重要。诊断方法采用静脉肾盂造影、超声检查和选择性肾血管造影。自1976年以来，我们的治疗方法包括术前肿瘤照射、肾切除术、术后肿瘤床照射和辅助化疗（放线菌素D、长春新碱和阿霉素）。肺和肝转移灶是化疗的范畴，联合放疗（有发生肺炎和中毒性肝炎的危险），最终可能需要进行切除。正如我们从美国了解到的（生存率75%），只有肿瘤学团队的良好合作才能提高这种肿瘤的治愈率。
