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The pioneering work of Gross and Neuhauser26 indicated that early surgery and routine postoperative irradiation gave the best survival rates in children with Wilms' tumor, and it has become standard practice in many centers to deliver routine postoperative irradiation to the tumor bed of these patients. The meticulous accuracy essential in pediatric radiotherapy is assisted greatly by consultation, between the surgeon and the radiotherapist, in the operating room at the time of surgery. In this way, zones of doubtful involvement, the advisability of extending the surgical procedure or curtailing it, and similar decisions can be reached jointly. It is often helpful to have metal clips placed around the margins of the tumor bed and similarly to identify suspicious zones of tumor involvement. Radiotherapy is initiated shortly after surgery, often on the same day, since there is no need to await wound healing, and because children tolerate radiation therapy very
D'Angio GJ. Radiation Therapy in Wilms' Tumor. JAMA. 1968;204(11):987-988. doi:10.1001/jama.1968.03140240043012