Single versus Multiple Dose Dactinomycin Therapy of Wilms's Tumor

Sixty-four children with resectable forms of Wilms's tumor, 12 months of age or older, were selected at random for treatment either with a single course of dactinomycin or to maintenance dactinomycin therapy given intermittently for 15 months in addition to postoperative radiotherapy. Twenty-two patients in one group and 23 in the other were acceptable for evaluation of treatment. Eighty-six per cent of the subjects (19 of 22) given maintenance chemotherapy have had no recurrence to date as compared to 48 per cent (11/23) without recurrence in the group given a single course of dactinomycin. This difference is statistically significant. Toxicity from dactinomycin in the dosage used has been minimal despite concurrent radiotherapy.