Wilms Tumour Clinical Trial
Official title:
Collaborative Wilms Tumour Africa Project
Significant progress has been made in the treatment of Wilms tumor in high income countries,
where survival is now around 85% - 90%. Survival in low income countries is much lower;
specific challenges include late presentation, malnutrition, less intense supportive care
facilities and failure to complete treatment.
A comprehensive treatment guideline was introduced in Malawi in 2006 which included
nutritional support and social support to enable parents to complete treatment. Survival has
increased to around 50%; 95% of children completed their treatment. A multi-disciplinary
group of African clinicians and 'state of the art' experts produced a consensus treatment
guideline for children with Wilms tumor in sub-Saharan Africa. This guideline will be
implemented as a multi-center prospective clinical trial in 2014 in six - eight institutes,
expecting about 200 new patients per year.
The hypothesis is that 2 year event free survival will be 50%, with <10% failure to complete
treatment and <10% treatment related mortality. Other research questions include efficacy and
toxicity of preoperative chemotherapy and the comparison of surgical staging, local pathology
and central review pathology in stratifying postoperative chemotherapy.
Patients are treated according to standard care. Data are documented on presentation at diagnosis, response of the tumor, findings at surgery and pathology, treatment given and outcome of the patients. ;