TOWARDS FURTHER REFINEMENT OF RADIOTHERAPY STRATIFICATION IN CHILDREN WITH NEPHROBLASTOMA

Abstract

Childhood renal tumours account for ~ 7% of all paediatric malignancies. Among them, Wilms tumour (WT), or nephroblastoma, is by far the most frequent. The current treatment strategies lead to ~90% overall survival in localised disease and ~ 80% in metastatic patients, yet not all patients with WT can be cured. These excellent outcomes are associated with the development of short- as well as long-term treatment-related side effects. Through the years, risk-adapted strategies have been implemented in the consecutive protocols of the existing international collaborative renal tumour groups to further improve survival while reducing treatment toxicity. The aim of this thesis was to contribute to the identification of WT patient subgroups that may benefit from the omission of radiotherapy and, in doing so, helping the decrease of the radiotherapy-related adverse effects.