[Progress in the treatment of children with Wilms' tumor in the Department of Pediatric Oncology at the Institute of Mother and Child].

A retrospective analysis of treatment results of 242 children with Wilms tumor treated in the years 1962-1989 is presented. The patients (pts) were divided into 4 groups according to methods of treatment that changed with the time. Group I consisted of patients treated between 1962-1965. Surgery followed by radiotherapy (RTX) and monochemotherapy (CHT) (ACTD) were the main treatment methods. Group II consisted of 68 patients treated between 1966-1974. In this group, surgery was followed by RTX and CHT (multiple courses of ACTD + VCR). Group III included 68 patients treated between 1975-1982. Preoperative RTX (20 Gy) and CHT (ACTD) were administered. RTX (total 35 Gy) and adjuvant CHT were continued after surgery. Group IV consisted of 62 patients treated in 1982-1989. Preoperative CHT (ACTD, VCR +/- ADR) was introduced. Adjuvant treatment depended on stage and histology of the tumor. The treatment results were as follows: 27, 66.1, 38.2 and 85.4% of survival, respectively. This points to the beneficial role of induction CHT, delayed surgery with adjusting the intensity of further adjuvant treatment to stage and tumor histology.