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Wilms Chemotherapy and Treatments

Also see:
What is Wilms
 
Wilms Stages
 
  Wilms Chemotherapy & Treatments
 
  Future of Wilms Research and Clinical Trials
 
  Organisations providing help and support
 

Chemotherapy drugs used to treat Wilms Tumours

Please note that all chemotherapy drugs mentioned here are not necessarily given to every stage of Wilms tumour and treatment and administration is dependent upon tumour stage and protocol. Please discuss any concerns or questions you have with your oncology specialist.

Vincristine (Oncovin®)

Vincristine is a chemotherapy drug given to treat Wilms tumours which is given via a central line. It is usually administered via a bolus (quick) dose over a number of minutes.

Dactinomycin (Cosmegen Lyovac®)

Dactinomycin is a chemotherapy drug given to treat Wilms tumour. It's sometimes called actinomycin D and is given via a central line, usually as a bolus (quick) dose over a number of minutes.

Doxorubicin

Doxorubicin is a chemotherapy drug given via a central line in a continuous infusion over a number of hours to treat Wilms tumour. The stage of the tumour will indicate whether this drug is recommended and you should discuss this with your oncology specialist if you have any queries|. It used to be called Adriamycin, and some doctors and nurses still use this name.

Cyclophosphamide

Cyclophosphamide is a chemotherapy drug which is used for high risk, stage IV and V and recurrent or relapsed Wilms tumour.

It is usually given via a central line with a continuous infusion over a number of days and in conjunction with Mesna (Uromitexan ®) which is used to protect the bladder from the effects of the cyclophosphamide. Mesna is not a chemotherapy drug.

Etoposide (VP-16, Etopophos®, Vepesid®)

Etoposide is a chemotherapy drug that is used for recurrent and relapsed tumours and also high risk and stage IV and V Wilms tumours. It is usually given via central line through an infusion over approximately 60 mins. It can also be used as a palliative chemotherapy drug and as an oral or tablet solution.

Carboplatin

Carboplatin is a chemotherapy drug given for high risk, relapsed and recurrent and also higher stage IV and V Wilms tumours. It is administered via a central line over approximately 60 minutes.

Melphalan (Alkeran®)

Melphalan is a high dose chemotherapy that is given to children with Wilms tumour in conjunction with a stem cell transplant as part of the relapse protocol. It is administered via a central line and usually in a specialist regional cancer centre. Your child will need to be monitored closely over a number of weeks and will require daily GCSF injections or infusions to help the immune system recover. Talk to your oncology professional for detailed information about this treatment if recommended for your child.

Topotecan (Hycamtin®)

Topotecan is a chemotherapy drug that can be considered for recurrent, resistant and relapsed Wilms tumours that do not respond to first or salvage treatment regimes. It is currently in a phase 2 clinical study. Your oncology specialist will be able to advise you if this is something that may be a consideration for your child

Article: Topotecan is active against Wilms' tumor: results of a multi-institutional phase II study

 
Other Treatments associated with Wilms tumour

G-CSF (granulocyte-colony stimulating factor)

G-CSF is a drug that may be used during chemotherapy treatment to stimulate production of white blood cells and neutrophils to shorten the time a child is neutropenic and to allow chemotherapy and other treatments to take place within desired time scales. It can be administered daily via injection or via infusion. Your oncology specialist will advise you if this is appropriate for your child and also the recommended administration method.

 

Co-trimoxazole (Septrin®)

Co-trimoxazole is an antibiotic used to prevent and treat a type of chest infection called Pneumocystis Jiroveci pneumonia.

You may hear the doctors and nurses referring to this as ‘PCP’ as it was previously called Pneumocystis Carinii pneumonia. This infection is due to an organism (bug) that is probably present in most people’s lungs. Children who are receiving chemotherapy for wilms tumour, which interferes with the body’s ability to cope with infections may be more at risk from this type of pneumonia. The symptoms of this infection are a raised temperature, rapid breathing and a dry cough.

Autologous (your own child’s) stem cell transplant for Wilms tumour

A stem cell transplant (sometimes called an autologous stem cell transplant) allows your child to have much higher doses of chemotherapy than usual. This can improve the chance of curing their cancer and is used for very high risk and also relapsed Wilms tumour in conjunction with high dose Melphalan mentioned above. Your child will usually begin a course of GCSF stimulating drug prior to the collection of stem cells and this will be co-ordinated and planned by the specialist stem cell team and your oncology professional. Stem cells are collected and then given back to the child after they receive the high dose chemotherapy.

Radiotherapy for children with Wilms tumour

Radiotherapy is sometimes used to treat children with Wilms tumours. Radiotherapy treats cancer by using high-energy rays directed to areas of the body where the cancer may have spread.

Further reading:

Radiotherapy for children with cancer in the chest area

Radiotherapy for children with cancer in the abdomen (tummy) and pelvis

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