Significance and management of computed tomography detected pulmonary nodules: a report from the National Wilms Tumor Study Group

摘要: Abstract Purpose: To define the optimal treatment for children with Wilms tumor who have pulmonary nodules identified on chest computed tomography (CT) scan, but a negative radiograph, we evaluated outcome of all such patients randomized or followed National Tumor Study (NWTS)-3 and -4. Patients Methods: We estimated event-free overall survival percentages 53 favorable histology tumors densities only by CT scan (CT-only) were treated as Stage IV intensive doxorubicin-containing chemotherapy whole-lung irradiation, compared these to 37 CT-only less aggressively based extent locoregional disease 2 3 drugs, without irradiation. Results: The 4-year 89% 91%, respectively. according 80% 85%, differences observed between groups not statistically significant. Among received there fewer relapses, more deaths attributable lung toxicity. Conclusions: current data raise possibility that receive whole irradiation greater number due role in this group cannot be definitively determined present data. Prolonged follow-up is necessary accurately estimate frequency late, treatment-related mortality.