Orditura M, De Vita F, Catalano G
Department of Internal and Experimental Medicine F. Magrassi, II University of Naples School of Medicine, Italy.
Cancer. 1997 Nov 15;80(10):1961-5. doi: 10.1002/(sici)1097-0142(19971115)80:10<1961::aid-cncr13>3.0.co;2-w.
Wilms' tumor in an adult is rare and no treatment guidelines have been established, although all authors recommend aggressive therapy based on surgery, radiotherapy, and multiagent chemotherapy.
The authors describe a case of Wilms' tumor in a 23-year-old woman who developed hepatic and pulmonary metastases after undergoing nephrectomy. Treatment was initiated with carboplatin, etoposide, ifosfamide, and epirubicin combination chemotherapy and irradiation of the tumor bed, lungs, and liver.
Metastatic workup was negative 41 months after suspension of chemoradiotherapy. Hematologic toxicity was high, but was manageable with adequate supportive care.
Because this multimodal treatment, which included a chemotherapeutic regimen with single agents generally used in patients with recurrent disease, had impressive activity in this patient with an advanced adult Wilms' tumor, the issue of further investigation of this alternative schedule is raised.
成人肾母细胞瘤罕见，尽管所有作者均推荐基于手术、放疗和多药化疗的积极治疗，但尚未制定治疗指南。
作者描述了一例23岁女性肾母细胞瘤病例，该患者在肾切除术后发生肝和肺转移。治疗开始采用卡铂、依托泊苷、异环磷酰胺和表柔比星联合化疗，并对肿瘤床、肺和肝脏进行照射。
放化疗停止41个月后，转移检查结果为阴性。血液学毒性较高，但通过充分的支持治疗可控制。
由于这种多模式治疗，包括通常用于复发性疾病患者的单药化疗方案，在这名晚期成人肾母细胞瘤患者中具有显著疗效，因此提出了进一步研究这种替代方案的问题。
