The role of chemotherapy in the treatment of Wilms' tumor.

The records of one hundred seventy-six patients with Wilm's tumor treated with transabdominal nephrectomy only or transabdominal nephrectomy, post-operative radiation therapy and several chemotherapy programs were reviewed. Three conclusions were reached: 1) The addition of postoperative radiation therapy and adjuvant chemotherapy has not improved the excellent, disease-free survival of patients with Stage I disease who were less than twenty-four months of age at diagnosis; 2) The addition of postoperative radiation therapy and adjuvant single agent chemotherapy has not improved the disease-free survival of patients with Stage II disease who were over twelve months of age at diagnosis; and 3) The use of combination chemotherapy with vincristine and actinomycin D has improved the disease-free survival of patients who present with Stage II disease.