Thamm D H, Mauldin E A, Vail D M
Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 53706, USA.
J Vet Intern Med. 1999 Sep-Oct;13(5):491-7. doi: 10.1892/0891-6640(1999)013<0491:pavcfc>2.3.co;2.
Forty-one dogs with mast cell tumors (MCTs) were treated with oral prednisone and injectable vinblastine (VBL), both in the adjuvant setting (23 dogs) and in dogs with gross disease (18 dogs). Adverse effects were noted in 20% (8/41) of the patients, usually after the 1st dose of VBL. Adverse effects were considered mild in 6, and severe, necessitating treatment discontinuation, in 2 (5%). Overall response rate in the evaluable dogs with gross disease was 47% (7/15), consisting of 5 complete responses and 2 partial responses. Median response duration was 154 days (24 to >645 days). As adjuvant therapy to incomplete surgical resection, prednisone and VBL conferred a 57% 1- and 2-year disease-free rate. Median survival time (MST) for the entire patient population was not reached with a median follow-up of 573 days; however, the MST for dogs with grade III MCT was 331 days, with 45% of dogs alive at 1 and 2 years. This is an apparent improvement over historical survival data employing surgery alone. Upon univariate analysis, significant prognostic factors (P < .05) for survival included presence of a locally recurrent tumor, presence of gross disease, argyrophilic nucleolar organizer region frequency, lymph node status, histologic grade, previous chemotherapy, and ulceration of the tumor. Similar criteria were significant when analyzed for time to treatment failure. Response to therapy was also predictive of survival in the gross disease group. Upon multivariate analysis, histologic grade (P = .012) and presence of a locally recurrent tumor (P < .001) were significant factors for survival.
41只患有肥大细胞瘤（MCT）的犬接受了口服泼尼松和注射长春碱（VBL）治疗，其中23只犬用于辅助治疗，18只犬用于治疗肉眼可见病变。20%（8/41）的患者出现不良反应，通常在首次注射VBL后出现。6例不良反应被认为轻微，2例（5%）严重，需要停药。在可评估的有肉眼可见病变的犬中，总体缓解率为47%（7/15），包括5例完全缓解和2例部分缓解。中位缓解持续时间为154天（24至>645天）。作为不完全手术切除的辅助治疗，泼尼松和VBL的1年和2年无病生存率为57%。整个患者群体的中位生存时间（MST）在中位随访573天时未达到；然而，III级MCT犬的MST为331天，1年和2年时45%的犬存活。这明显优于仅采用手术的历史生存数据。单因素分析显示，生存的显著预后因素（P<0.05）包括局部复发肿瘤的存在、肉眼可见病变的存在、嗜银核仁组织区频率、淋巴结状态、组织学分级、先前的化疗以及肿瘤溃疡。分析治疗失败时间时，类似标准也具有显著性。在有肉眼可见病变的组中，治疗反应也是生存的预测因素。多因素分析显示，组织学分级（P = 0.012）和局部复发肿瘤的存在（P<0.001）是生存的显著因素。
