RESPONSE OF UNTREATED STATE-IV WILMS-TUMOR TO SINGLE-DOSE CARBOPLATINASSESSED BY UP FRONT WINDOW THERAPY

A total of nine children with previously untreated stage IV Wilms' tum or of favorable histology were treated according to the Austrian/Hunga rian Wilms' Tumor Protocol 89 and received a preoperative single dose of carboplatin as an ''up front'' window therapy. The treatment consis ted of carboplatin as a single-dose of 600 mg/m2 over 30 minutes on da y 1. Response evaluation by chest X-ray, serial CT scans, and sonograp hy was performed on day 22. Investigation of the abdominal tumors reve aled seven partial responses (78%), one nonresponse, and one progressi ve disease with a median tumor volume reduction of 62%. Response of me tastases evaluated by CT scans was as follows: four complete remission , four partial response, and one nonresponse. Thrombocytopenia (WHO gr ade III 1, grade II 2, grade I 2) and leukocytopenia (WHO grade II 1, grade I 5) were the main side effects. No renal or liver toxicity were observed. The overall response rate after a preoperative single-dose of 600 mg/m2 carboplatin in untreated patients with stage IV Wilms' tu mor is encouraging and the toxicity acceptable. This data indicate tha t carboplatin seems to be an additional effective drug in patients wit h previously untreated Wilms' tumor of favorable histology. (C) 1995 W iley-Liss, Inc.