A trial looking at treatment for children and young people with Wilms' tumour and clear cell sarcoma of the kidney (UKW-R WT 2001 02)

There are 3 treatment groups in this trial. Your doctor will explain which group you are in. This depends on a number of factors including

• The stage of your cancer - whether the cancer is contained within the kidney or if it has spread outside the kidney to another part of the body
• The treatment you have already had
• How the cancer cells look under the microscope (the histology )
• Blood test results

Before your treatment begins, you will have a central line or long line put in. This is also sometimes called a ‘wiggly line’. It makes it easier to give chemotherapy and take blood samples.

If you are in group 1, you have the following chemotherapy drugs

• vincristine
• dactinomycin (Actinomycin D)
• doxorubicin (Adriamycin)

If you are in group 2, you have chemotherapy with

• cyclophosphamide
• etoposide
• doxorubicin

For groups 1 and 2, further treatment after chemotherapy will depend on how well the treatment has worked. You may have radiotherapy, surgery, or a combination of these.

You may have an operation to remove any remaining cancer. For example, abdominal surgery, or lung surgery if cancer has spread to the lungs. If surgery to remove remaining cancer isn’t possible, you may have radiotherapy, for example, to the abdomen, lungs or liver.

If you are in group 3, you have carboplatin, etoposide and cyclophosphamide. If this chemotherapy is working, you have your stem cells or bone marrow collected in preparation for a transplant. This is called a stem cell harvest or a bone marrow harvest .

You then have high dose melphalan, followed by a stem cell or bone marrow transplant.

You may need further treatment with radiotherapy or surgery, as with groups 1 and 2. If you have surgery, you have your operation before high dose chemotherapy and a transplant. If you have radiotherapy, you have this after your transplant.