Howell Jackson, Maughan Benjamin, Fluchel Mark, Poppe Matthew
Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
Urol Case Rep. 2024 Jul 15;56:102799. doi: 10.1016/j.eucr.2024.102799. eCollection 2024 Sep.
The optimal treatment of adult-onset Wilms tumors (WTs) in elderly patients is a debated area, as pediatric protocols are thought to carry unacceptable toxicity. We treated a 62-year-old female with good performance status and Stage IV (T1b N1 M1) favorable histology WT using pediatric adjuvant and salvage chemoradiation protocols. Though she experienced nodal relapse and both adjuvant and salvage treatment were discontinued early due to toxicity, she obtained excellent oncologic outcomes, having remained disease-free for 32 months. We recommend considering pediatric protocols for elderly WT patients with good performance status, anticipating dose reductions and possible early chemotherapy termination.
老年患者成人期肾母细胞瘤（WT）的最佳治疗方法是一个存在争议的领域，因为人们认为儿科治疗方案具有不可接受的毒性。我们使用儿科辅助和挽救性放化疗方案治疗了一名62岁、体能状态良好且组织学类型为IV期（T1b N1 M1）的预后良好型WT女性患者。尽管她出现了淋巴结复发，且由于毒性反应辅助治疗和挽救性治疗均提前中断，但她获得了优异的肿瘤学结局，已无病生存32个月。我们建议对于体能状态良好的老年WT患者考虑采用儿科治疗方案，同时预期进行剂量减少并可能提前终止化疗。
