Combination Chemotherapy With or Without Radiation Therapy in Treating Young Patients With Newly Diagnosed Stage III or Stage IV Wilms Tumor

DISEASE CHARACTERISTICS:

• Newly diagnosed Wilms tumor meeting 1 of the following criteria:

  • Stage IV disease with favorable histology with or without loss of heterozygosity (LOH) for 1p and 16q
  • Stage III disease with favorable histology with LOH for 1p and 16q transferring from clinical trial COG-AREN0532
• Patients must begin therapy within 14 days after surgery or biopsy (day 0), unless medically contraindicated
• Extra-pulmonary metastases include lymph node involvement in the hilum and/or mediastinum deemed by the treating institution to represent malignant disease, or positive cytology-proven pleural effusions

• No bilateral Wilms tumors (stage IV)

  • Patients should be referred to COG-AREN0534
• Previously enrolled in clinical trial COG-AREN03B2

PATIENT CHARACTERISTICS:

• Karnofsky performance status (PS) 50-100% (for patients > 16 years of age) OR Lansky PS 50-100% (for patients ≤ 16 years of age)
• Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• AST or ALT < 2.5 times ULN
• Shortening fraction ≥ 27% by echocardiogram OR ejection fraction ≥ 50% by radionuclide angiogram
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior tumor-directed chemotherapy or radiotherapy unless transferring from clinical trial COG-AREN0532 OR treatment for emergent issues, as medically indicated
• No concurrent aprepitant