title: Second neoplasms after Wilms' tumor in childhood.
abstract: The frequency of second neoplasms was examined among 487 Wilms' tumor patients treated at the Dana-Farber Cancer Institute and Children's Hospital of Boston, 1927-81. Thirty study patients (6%) developed second primary tumors: 11 cancers, 16 benign tumors, and 3 borderline neoplasms. Cumulative probability of a second cancer was 18% (standard error, 6%) in 34 years after diagnosis of Wilms' tumor. The subgroup of 412 patients who had received radiotherapy for Wilms' tumor developed all 11 second cancers, which included 1 skin carcinoma, 1 acute leukemia, and 9 solid internal cancers (expected, 0.7 cancers other than skin carcinoma; P less than .001). After exclusion of the secondary leukemia, all but 1 second cancer arose within the radiotherapy field. Concurrent therapy with dactinomycin did not reduce the risk of a radiation-associated cancer. Second cancer was the cause of death in 7 patients.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D011336:Probability; D011878:Radiotherapy / Q000009:adverse effects; D012306:Risk; D013997:Time Factors; D009396:Wilms Tumor / Q000150:complications* / Q000401:mortality / Q000628:therapy
chemical_list: D003609:Dactinomycin