D'Angio G J, Evans A, Breslow N, Beckwith B, Bishop H, Farewell V, Goodwin W, Leape L, Palmer N, Sinks L, Sutow W, Tefft M, Wolff J
Cancer. 1981 May 1;47(9):2302-11. doi: 10.1002/1097-0142(19810501)47:9<2302::aid-cncr2820470933>3.0.co;2-k.
One-hundred-eighty-eight children up to 16 years of age were randomized in the second National Wilms' Tumor Study (NWTS) with tumors that were confined to the kidney and that had been totally excised (Group I). Most fared well whether treated for six or for 15 months with both actinomycin D (AMD) and vincristine (VCR). No postoperative radiation therapy (RT) was given. The two-year relapse-free survival (RFS) and two-year survival rates were 88 and 95%, respectively. Two-hundred-sixty-eight randomized patients with more advanced local lesions (Groups II and III) and 57 with distant metastases (Group IV) had postoperative RT and were scheduled for 15 months treatment with either AMD and VCR (Reg. C) or AMD plus VCR plus Adriamycin (Reg. D). The 77% two-year RFS rate for Reg. D was significantly different from the 63% with Reg. C. As in the first NWTS, patients with tumors of unfavorable histology (UH) had a significantly worse prognosis than those with favorable histology (FH), as did those with positive nodes. Survival rates at two years were 54% for UH vs. 90% for FH, and 54% vs. 82% for those with and without lymph node involvement.
在第二次全国肾母细胞瘤研究（NWTS）中，188名16岁以下、肿瘤局限于肾脏且已完全切除的儿童被随机分组（I组）。大多数儿童无论接受6个月还是15个月的放线菌素D（AMD）和长春新碱（VCR）联合治疗，情况都良好。未进行术后放射治疗（RT）。两年无复发生存率（RFS）和两年生存率分别为88%和95%。268名局部病变更严重的随机分组患者（II组和III组）以及57名有远处转移的患者（IV组）接受了术后RT，并计划接受15个月的AMD和VCR联合治疗（方案C）或AMD加VCR加阿霉素治疗（方案D）。方案D的两年RFS率为77%，与方案C的63%有显著差异。与第一次NWTS一样，组织学不良（UH）肿瘤患者的预后明显比组织学良好（FH）患者差，有阳性淋巴结的患者也是如此。UH患者的两年生存率为54%，而FH患者为90%；有和无淋巴结受累患者的两年生存率分别为54%和82%。
