Treatment for Very Low and Standard Risk Favorable Histology Wilms Tumor

This phase III trial is studying vincristine, dactinomycin, and doxorubicin with or without
radiation therapy or observation only to see how well they work in treating patients
undergoing surgery for newly diagnosed stage I, stage II, or stage III Wilms' tumor. Drugs
used in chemotherapy, such as vincristine, dactinomycin, and doxorubicin, work in different
ways to stop the growth of tumor cells, either by killing the cells or by stopping them from
dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving these
treatments after surgery may kill any tumor cells that remain after surgery. Sometimes, after
surgery, the tumor may not need additional treatment until it progresses. In this case,
observation may be sufficient.