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The following are treatment options for stage II 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 stage II Wilms tumour with favourable histology involves surgery to remove the cancer, followed by chemotherapy. Treatment for stage II Wilms tumour with unfavourable (anaplastic) histology involves surgery to remove the cancer, followed by radiation therapy to the abdomen and chemotherapy.
Surgery is the primary treatment for both types of stage II Wilms tumour. The surgery used is radical nephrectomy with lymph node removal.
Chemotherapy is used after surgery for stage II Wilms tumour. For tumours with unfavourable (anaplastic) histology, chemotherapy is given after radiation therapy to the abdomen. The type of chemotherapy most commonly used is based on the type of tumour.
Favourable histology tumours are treated with vincristine (Oncovin) and dactinomycin (Cosmegen, actinomycin-D). Chemotherapy is given for 19 weeks after surgery.
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.
Focal anaplastic tumours are treated with vincristine, doxorubicin and dactinomycin. These drugs are given for 25 weeks after surgery and radiation therapy.
Diffuse anaplastic tumours are treated with vincristine, doxorubicin, etoposide (Vepesid) and cyclophosphamide (Cytoxan, Procytox) for 25 weeks. Some children receiving treatment in a clinical trial may also receive carboplatin (Paraplatin, Paraplatin AQ) in addition to these drugs.
When cyclophosphamide is used, mesna (Uromitexan) is also given. Mesna helps protect the bladder from irritation from cyclophosphamide.
Radiation therapy is sometimes given as part of treatment for anaplastic stage II Wilms tumour. Radiation therapy to the abdomen is given after surgery, along with chemotherapy.
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 that are used. Find out more about clinical trials.