Skylar R Sylvester, Joshua G Henry, Parminder S Basran, Margaret C McEntee
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引用次数: 0
摘要
姑息性放射治疗可以减轻癌症犬的疼痛和临床症状,但最佳的分割方案尚不清楚。本回顾性病例系列的目的是评估108只接受周期性“QUAD”低分割姑息性放射治疗方案治疗的宏观实体瘤犬的临床获益、客观反应、不良反应和结局。QUAD中位剂量为14 Gy (14-16 Gy)。中位总剂量为28 Gy (14-48 Gy)。临床获益率为93%,首次QUAD后21天主观缓解中位发作,持续中位时间为134天。36只狗在第三次QUAD前用CT评估肿瘤体积客观反应,24只狗(67%)病情稳定,9只狗(25%)部分反应。32只和30只狗的鼻腔和口腔是最常见的肿瘤部位。中位无进展生存期为153天(95% CI 114-200)。中位总生存期为212天(95% CI 152-259)。QUAD周期完成的次数、获得的临床获益、接受的抗炎治疗、总辐射剂量、达到最大临床获益的时间和反应持续时间与无进展和总生存期呈正相关。15只狗(14%)出现急性毒性,3只狗(3%)出现重度(3级)毒性。31只狗(29%)出现轻度(1级和2级)晚期皮肤和眼部毒性,主要是白斑病、脱发、干枯性角膜结膜炎和白内障。本报告表明,QUAD辐射是一种替代方案,可考虑缓解犬不能手术或晚期实体肿瘤。
Description and efficacy of a response-based "QUAD" cyclical hypofractionated palliative-intent radiation protocol in dogs with macroscopic solid tumours: 108 cases.
Palliative-intent radiation therapy can alleviate pain and clinical signs in dogs with cancer, but optimal fractionation scheme is unknown. The objective of this retrospective case series is to evaluate clinical benefit, objective response, adverse effects, and outcomes in 108 dogs with macroscopic solid tumours treated with a cyclical "QUAD" hypofractionated palliative-intent radiation therapy protocol. Median QUAD dose was 14 Gy (14-16 Gy). Median total dose was 28 Gy (14-48 Gy). Clinical benefit rate was 93%, with median onset of subjective palliation 21 days after the first QUAD, lasting a median of 134 days. Tumour volumetric objective response was assessed with CT prior to the third QUAD in 36 dogs, with stable disease in 24 dogs (67%) and partial response in 9 dogs (25%). Sinonasal and oral were the most common tumour locations in 32 and 30 dogs, respectively. Median progression-free survival was 153 days (95% CI 114-200). Median overall survival was 212 days (95% CI 152-259). Number of QUAD cycles completed, clinical benefit achieved, anti-inflammatory received, total radiation dose, time to maximum clinical benefit, and response duration were positively associated with progression-free and overall survival. Acute toxicities were observed in 15 dogs (14%) with 3 high-grade (grade 3) toxicities (3%). Low-grade (grade 1 and 2) late skin and ocular toxicities were observed in 31 dogs (29%), predominantly leukotrichia, alopecia, keratoconjunctivitis sicca, and cataracts. This report demonstrates that QUAD radiation is an alternative protocol to be considered for palliation of dogs with inoperable or advanced stage solid tumours.
期刊介绍:
Veterinary and Comparative Oncology (VCO) is an international, peer-reviewed journal integrating clinical and scientific information from a variety of related disciplines and from worldwide sources for all veterinary oncologists and cancer researchers concerned with aetiology, diagnosis and clinical course of cancer in domestic animals and its prevention. With the ultimate aim of diminishing suffering from cancer, the journal supports the transfer of knowledge in all aspects of veterinary oncology, from the application of new laboratory technology to cancer prevention, early detection, diagnosis and therapy. In addition to original articles, the journal publishes solicited editorials, review articles, commentary, correspondence and abstracts from the published literature. Accordingly, studies describing laboratory work performed exclusively in purpose-bred domestic animals (e.g. dogs, cats, horses) will not be considered.