RESUMO
Objective To analyze the efficacy and toxicity of WT-2016 regimen by comparing the clinical effects between WT-2016 and NWTS-5 chemotherapy regimens in treating children with Wlims tumor(WT). Methods We reviewed clinical data of children with WT initially treated in Children's Hospital of Chongqing Medical University from January 2014 to February 2019. The staging and classification was determined according to the NWTS standards. The chemotherapy regimen was chosen between WT-2016 or NWTS-5 program. Event free survival (EFS) and overall survival (OS) curves were estimated using the Kaplan-Meier method and compared using the log-rank test. The relapse rate, myelosuppression rate, sepsis rate, and the incidence of pulmonary infection or abnormal liver function were compared using chi-square test. Results Of 116 children, 40 patients were treated with chemotherapy regimen WT-2016 and 76 were treated with chemotherapy regimen NWTS-5. The follow-up duration was 10.8 months (range from 5.8 to 26.6 months) and 39.2 months (range from 4.5 to 66.5 months), respectively. Two-year OS estimate was 86.6% and 88.1% (P=0.64), respectively; two-year EFS estimate was 80.0% and 74.9% (P=0.90), respectively. Overall relapse rate was 7.5% and 25.0% (P=0.02), respectively. The grade myelosuppression rate was 42.5% and 19.7% (P=0.01), respectively. Moreover, the relapse rate in children with low-stage tumors was 7.7% and 16.2% (P=0.77), respectively, and that in high-stage tumors was 7.4% and 33.3% (P=0.03), respectively. The relapse rate in children with non-anaplastic tumors was 9.1% and 22.6% (P=0.18), respectively; that in anaplastic tumors was 0% and 35.7% (P=0.12), respectively. The grade myelosuppression rate in children with low-stage tumors was 23.1% and 0% (P=0.01), respectively; that in high-stage tumors was 51.9% and 38.5% (P=0.28), respectively. The grade myelosuppression rate in children with non-anaplastic tumors was 30.3% and 19.4% (P=0.35), respectively; that in anaplastic tumors was 100% and 21.4% (P<0.01), respectively. In addition, there was no significant difference in the incidence of sepsis, pulmonary infection or abnormal liver function. Conclusion WT-2016 chemotherapy regimen is associated with significantly decreased relapse rate and increased incidence of myelosuppression in children with WT campared with NWTS-S regimen.