Survival Following Brain Metastases in Wilms' Tumor

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Abstract
While overall mortality in Wilms'' tumor has decreased due to the addition of effective chemotherapy to surgery and radiotherapy in the treatment of this malignancy, this child''s survival with cerebral metastases is distinctly unusual. The reason for the development of an altered behavioral pattern together with perceptual dysfunction, which is manifested at present primarily as a reading disability, is not clear. Her age at the time of development of this problem (6 yr), beginning school at the same time, and the concerned attitudes of parents towards their children with cancer could be considered as psychological causes of the altered behavioral pattern, but would probably not account for what was revealed on psychological testing. The problem to be considered in this child, and all children receiving necessarily aggressive radiotherapy and chemotherapy for their disease, is whether or not this therapy is responsible for the development of abnormalities in various organ systems. In this child, it would be difficult to dissociate the one-time presence of metastatic brain tumor with the ultimate occurrence of her present symptoms. Logical, aggressive, anti-cancer therapy has been important in the improved survival of several childhood cancers, and such therapy should be continued with the systematic, careful, follow-up evaluations necessary to detect not only recurrence of disease but the development of complications associated with or following such therapy.

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