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Abstract
Two recent publications have highlighted toxic effects involving the liver in children treated for Wilms' tumor, and the possible role of actinomycin D (AMD). In a letter to the editor of Cancer Treatment Reports, Dr. G. D'Angio, on behalf of the National Wilms' Tumor Study Committee, warned of profound hepatotoxicity experienced in 5 of 40 children receiving AMD in a single injection of 60 µg/kg.1 Although standard regimens using five consecutive daily injections of AMD may be less hepatotoxic, these observations have prompted pediatric oncologists to revise the role of AMD with respect to liver dysfunction encountered in their population of children with Wilms’ tumor.