[The diagnostic and prognostic characteristics of nephroblastoma recurrences in children]. / Osobennosti diagnostiki i prognoza retsidivov nefroblastom u detei.

A total of 450 children with nephroblastoma were treated in the children's oncological department of the All-Union Cancer Research Centre, the USSR Academy of Medical Sciences, between 1976 and 1986. Tumour relapses were diagnosed during various terms of postsurgery in 131 (29.1 per cent) of them: true relapses in 58 (44.1); retroperitoneal lymph nodal metastases in 56 (42.7 per cent) and the both patterns in 17 (13.2 per cent) patients. The majority of the children were older than 3 years. The initial and the most common manifestations of nephroblastoma relapses were the following symptoms: weakness and diminished appetite (93.1 per cent) pale skin (78.6 per cent), abdominal pains (77 per cent), enlarged abdomen (73 per cent), a palpable tumour (82.4 per cent), neurological symptomatology: defecation and urination disorders (12.9 per cent), pareses and paralyses of lower extremities (6.8 per cent). Timely usage of diagnostic complex measures (palpation under the control of myorelaxants, ultrasonic and computed tomography, angiography) enables one to diagnose nephroblastoma relapses. Such histological patterns of nephroblastoma as nondifferentiated blastema, sarcomatoid and rhabdoid tumours were considered as prognostically unfavourable ones. More relapses were diagnosed in children over 4 years. Some cases of nephroblastoma relapses are also caused by the operative technique (lumbar incision in nephrectomy) and extension of the tumour (into the adjacent organs and tissues--Stage II disease). Pre- of intraoperative ruptures of tumour capsules is a principal factor contributing to relapses. Radiation and chemotherapy are found to be mandatory for the prevention of the ruptures.

[Adjuvant chemotherapy in the combined modality therapy of nephroblastoma in children]. / Ad"iuvantnaia khimioterapiia v kompleksnom lechenii nefroblastom u detei.

The paper discusses the end results of complex treatment of 31 children comprising preoperative therapy, nephrectomy and adjuvant chemotherapy. Two-year survival was 64.5% and two-year recurrence-free survival--48.4%. Adjuvant chemotherapy (vincristine, dactinomycin and adriamycin) was given to 25 cases. Complete treatment consisting of 4 courses of adjuvant chemotherapy was carried out in 12 patients only, tumor progression and toxic hepatitis being the most frequent causes of adjuvant treatment suspension. Survival was shown to depend on such prognostic factors as the efficacy of preoperative chemotherapy, stage and morphological pattern of tumor rather than adjuvant chemotherapy duration. Therefore, a short course of adjuvant chemotherapy may be recommended for localized nephroblastoma in pediatric patients.

[Evaluation of the effectiveness of preoperative polychemotherapy of nephroblastomas in children by angiography, ultrasonic tomography and computed tomography]. / Otsenka éffektivnosti predoperatsionnoi polikhimoterapii nefroblastom u detei metodami angiografii, ul'trazvukovoi i komp'iuternoi tomografii.

The results of preoperative polychemotherapy of nephroblastoma in 14 children are presented. Ultrasonic tomography, computed tomography and angiography were performed in all the patients before and after medication. The findings on the efficacy of polychemotherapy were assessed on the basis of surgical evidence and, in particular, resected material examination. A high diagnostic value of all the methods was demonstrated and criteria of the effectiveness of preoperative polychemotherapy as evaluated by application of ultrasonic and computed tomography and angiography were worked out. Optimal terms of carrying out diagnostic procedures in patients with nephroblastoma during preoperative treatment are suggested.

[Antitumor antibiotics in the treatment of nephroblastomas in children]. / Protivoopukholevye antibiotiki v lechenii nefroblastom u detei.

The results of the chemotherapy of 20 children with nephroblastoma are analysed. The patients were treated according to the following scheme: vincristine in a dose of 0.05 mg kg bw once a week on the 1st, 8th, 15th and 22nd days, dactinomycin in a dose of 15 micrograms/kg once a day for 3 days on the 1st, 2nd and 3rd days of adriamycin in a dose of 30-40 mg/m2 on the 15th day of the treatment course. The postoperative chemotherapy was started 10 days after the operation. It was performed in 4 courses with intervals of 3 weeks. The efficacy of the treatment was estimated with angiography, echography and computer-aided tomography. The above scheme proved to be efficient in the treatment of the children with nephroblastoma. Reliable control of the tumor size during the preoperative treatment was shown to be possible.