Pre-surgery chemo boosts Wilms' tumour treatment says study
Children being treated for the most common form of childhood kidney cancer, known as Wilms' tumour, show better treatment results if given chemotherapy before surgery, says new research.
The children who received the pre-surgical chemotherapy required less treatment and experienced fewer long-term side effects, said the Children's Cancer and Leukaemia Group study.
In the ten-year trial, supported by Cancer Research UK, a group of 205 Wilms' tumour patients were randomly assigned to receive either immediate surgery or six weeks of chemotherapy followed by surgery.
Depending on the size of their tumours, all patients then received chemotherapy, radiotherapy or a combination of the two to kill any remaining cancer cells.
Overall survival was the same in the two groups, but the researchers found that giving six weeks pre-operative chemotherapy enabled easier removal of tumours.
Also, 20 per cent fewer children given pre-operative chemotherapy needed radiotherapy or another powerful chemotherapy drug, doxorubicin, after their surgery, minimising their risk of long-term side effects.
The results of this trial are strong enough to conclude that pre-operative chemotherapy should be standard for the treatment of Wilms' tumours throughout the UK.
"Deciding what is the best way to treat Wilms' tumours has been under debate for many years and this study was the first time that the two treatment methods were compared in a randomised clinical trial," said lead researcher Dr Christopher Mitchell.
"We were able to identify a group of patients who could benefit from a reduction in treatment without compromising their survival chances.
"For some children with advanced tumours, delaying their surgery reduced the size of their tumours enough to prevent them needing intensive treatment after surgery.
"This improvement in quality of life for patients is significant and we hope children diagnosed with Wilms' tumours in the future will benefit from our findings."
The study was presented at the NCRI Cancer Conference and published in the European Journal of Cancer.