ABSTRACT
The crude 5-year survival rate among children with Wilms' tumour increased from 54% for those diagnosed from 1960 to 1965 to 81% for the period 1966 to 1971. This resulted from an increased ability to cure metastatic disease and, to a lesser extent, to an increased ability to prevent relapse. It is proposed that, after resection and postoperative irradiation, maintained combination chemotherapy with actinomycin D and vincristine should be used electively to prevent relapse, but that this use should also be selective in order that overall morbidity be minimized. Of urgent priority, therefore, is improved delineation of present-day prognostic factors in children with Wilms' tumour.
Subject(s)
Kidney Neoplasms/mortality , Kidney Neoplasms/therapy , Wilms Tumor/therapy , Dactinomycin/therapeutic use , Drug Therapy, Combination , Humans , Lung Neoplasms/mortality , Neoplasm Metastasis , Neoplasm Recurrence, Local/therapy , Nephrectomy , Postoperative Care , Prognosis , Radiotherapy Dosage , Vincristine/administration & dosage , Vincristine/therapeutic use , Wilms Tumor/mortalitySubject(s)
Lymphatic Diseases/congenital , Lymphocytosis/congenital , Child , Humans , Hyperplasia , Leukocyte Count , Lymph Nodes/pathology , Lymphatic Diseases/complications , Lymphocytosis/complications , Male , Splenectomy , Splenomegaly/complications , Splenomegaly/congenital , Splenomegaly/pathology , Splenomegaly/surgerySubject(s)
Adenocarcinoma, Papillary , Choriocarcinoma , Dysgerminoma , Granulosa Cell Tumor , Ovarian Cysts , Ovarian Neoplasms , Sertoli-Leydig Cell Tumor , Teratoma , Adolescent , Adult , Child , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Infant, Newborn , Pregnancy , PrognosisSubject(s)
Gastrointestinal Neoplasms , Lymphoma , Adolescent , Appendiceal Neoplasms , Child , Child, Preschool , Colonic Neoplasms , Duodenal Neoplasms , Female , Gastrointestinal Neoplasms/radiotherapy , Gastrointestinal Neoplasms/surgery , Humans , Ileum , Intestinal Neoplasms , Jejunum , Male , Stomach NeoplasmsSubject(s)
Hodgkin Disease/epidemiology , Hodgkin Disease/mortality , Hodgkin Disease/radiotherapy , Adolescent , Child , Child, Preschool , Female , Humans , MaleABSTRACT
Classification of radiation injury on a clinical basis is useful for determining priorities of evacuation and treatment in a mass casualty situation. Victims of nuclear attack would probably also suffer traumatic and thermal injuries. Four categories of surgical injury have therefore been combined with three categories of radiation injury to yield 12 classes of patients whose disposition is described. The treatment of the acute radiation syndrome is briefly discussed and concurrent injuries from trauma and burns and their possible implications are considered.
