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Wilms tumour

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Treatments for stage I Wilms tumour

The following are treatment options for stage I Wilms tumour. The healthcare team will suggest treatments based on your child’s needs and work with you to develop a treatment plan.

The healthcare team also considers the type of Wilms tumour when they plan treatments. Treatment for both favourable and unfavourable (anaplastic) histology involves surgery to remove the tumour, followed by chemotherapy.

Surgery

Surgery is the primary treatment for both types of stage I Wilms tumour. The surgery used is radical nephrectomy with lymph node removal.

Children younger than 2 years who have small tumours with favourable histology may only have surgery. This is still considered an experimental treatment. It would only be done in a clinical trial setting. These children need to be watched closely because the risk of recurrence is slightly higher without chemotherapy.

Chemotherapy

Chemotherapy is given after surgery for stage I Wilms tumour in children:

  • older than 2 years
  • with larger tumours
  • with tumours that have unfavourable (anaplastic) histology
  • chromosome changes

Favourable histology tumours are treated with vincristine (Oncovin) and dactinomycin (Cosmegen, actinomycin-D) for 19 weeks. Some centers treat stage I Wilms tumour in children less than 4 years of age with vincristine alone for 8 weeks.

Favourable histology tumours with chromosome changes are treated with vincristine and dactinomycin for 19 weeks. Some children receiving treatment in a clinical trial may also receive doxorubicin (Adriamycin) in addition to these drugs.

Unfavourable histology tumours are treated with vincristine and dactinomycin for 19 weeks. Some children receiving treatment in a clinical trial may also receive doxorubicin (Adriamycin) in addition to these drugs.

Clinical trials

Many children with Wilms tumour will be treated in a clinical trial that is tailored to the stage and type of tumour. The clinical trial protocol outlines the chemotherapy drugs and dosages used. Find out more about clinical trials.

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