Computed tomography (CT) of the lung should be performed in children confirmed as having stage I disease after surgery for treatment of Wilms’ tumor, clinicians in the UK suggest. Dr. C. M. Owens, of the Great Ormond Street Hospital for Children National Health Service Trust in London, and associates found that chest CT identifies children with stage I tumors who would perhaps benefit from combination chemotherapy.
As reported in the Journal of Clinical Oncology for June 15, the investigators retrospectively studied 141 patients whose chest x-rays were normal and who had lung CT performed at diagnosis. Pulmonary nodules were identified on CT scan in 31 patients.
Those with stage I disease had been treated with vincristine, and those with stage II had received vincristine plus dactinomycin. Additional treatment with doxorubicin and irradiation was given for unfavorable histology tumors or higher stage disease. Patients were followed for a median of 75 months.
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