Abstract
The multimodality treatment approach employing surgery, chemotherapy (ChT), and radiotherapy (XRT) has revolutionized the treatment of Wilms’ tumor over the decades. ChT has been the cornerstone of the treatment being provided and has led immeasurably towards the improved survival of these patients. The era of ChT started with the discovery of Actinomycin-D followed closely by the discovery of Vincristine. A fresh fillip was provided by the starting of multi-institutional studies by cooperative international study groups with National Wilms’ Tumor Study (NWTSG)/Children Oncology Group (COG), and International Society of Pediatric Oncology. These groups have been instrumental in refining the treatment of these children and have been able to stratify these children into various groups with “tailor-made” ChT regimens taking into account the various prognostic factors that are being identified. With evolution of these therapies, we have started to move beyond just a simple cure of the patient, towards a more holistic approach towards mitigation of long-term effects of these therapies with serious toxicities.
In this chapter, we would understand the history of systemic ChT and understand how it progressed over the years. We would also cover the nuance and difference in the various approaches to ChT, viz., NWTSG/COG and SIOP protocols. We would understand the evolution of these protocols and the current state of recommendations as it stands today and the common precautions and the long-term effects of these ChT.
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Sarin, Y.K., Sachdeva, P., Kalra, M., Jayakumar, T.K., Sinha, A. (2022). Chemotherapy. In: Sarin, Y.K. (eds) Wilms’ Tumor. Springer, Singapore. https://doi.org/10.1007/978-981-19-3428-5_19
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