Abstract
The effects of irradiation (XRT) combined with multiagent chemotherapy (CT) on compensatory renal hypertrophy following nephrectomy in childhood have received little attention. Treatment details and serial intravenous urograms in 30 children with Wilms' tumor subjected to nephrectomy and postoperative XRT and/or CT were reviewed. Eleven children received whole abdomen XRT (WAXRT) which delivered 1200-1300 rad to the remaining kidney. Nineteen patients were given no initial irradiation to the remaining kidney (OXRT) with 17 receiving renal fossa treatment only and 2 no irradiation. Renal growth, assessed by seriallceph-alocaudad measurements in treated patients, was plotted and compared to previously published figures of normal growth as well as hypertrophy following nephrectomy for benign causes in childhood. The mean and median slope of renal growth for the WAXRT group was 0.50 and 0.37 respectively while it was 0.56 and 0.50 for the OXRT group. The cumulative slope for the WAXRT group was 0.43 versus 0.55 for the OXRT group. When children who required subsequent pulmonary irradiation which necessarily irradiated the upper portion of the kidney were excluded from the OXRT group, the cumulative slope increased to 0.62. These results suggest a possible effect of low dose irradiation on renal hypertrophy.
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