Chun R, Garrett L D, Vail D M
UW-Madison School of Veterinary Medicine, Veterinary Medical Teaching Hospital, USA.
J Vet Intern Med. 2000 Mar-Apr;14(2):120-4. doi: 10.1892/0891-6640(2000)014<0120:eoahcp>2.3.co;2.
The purpose of this study was to evaluate the efficacy and toxicity of an intensified dose protocol with no maintenance phase for the treatment of canine lymphoma. Forty-nine dogs all weighing more than 15 kg were entered. Dogs were staged and treated with a modified version of the University of Wisconsin (UW)-Madison protocol for lymphoma. Modifications included increased dosages of cyclophosphamide (250 mg/m2 compared to 200 mg/m2) and doxorubicin (37.5 mg/m2 compared to 30 mg/m2), with no crossover to chlorambucil or methotrexate. After 25 weeks on protocol (17 treatments), therapy was discontinued and dogs were monitored for relapse on a monthly basis. Disease-free interval (DFI) and overall survival were compared to 55 historical controls treated with the UW-Madison protocol. The 2 groups were comparable with respect to age, sex, breed, stage, presence of hypercalcemia, and CD3 status; a trend toward more substage b dogs was present in the high-dose group (P = .076). When comparing response rate, DFI, death due to disease, and death due to treatment-related toxicity, more dogs were dead due to toxicity (P < .001; odds ratio = 8.8) in the high-dose group. Overall survival between the high-dose and control groups did not differ significantly (P = .55) at 270 and 318 days, respectively. The intensified dose protocol is an option for owners who are willing to risk higher toxicity for a shorter protocol with no statistical difference in survival from the UW-Madison protocol.
本研究的目的是评估一种无维持期的强化剂量方案治疗犬淋巴瘤的疗效和毒性。纳入了49只体重均超过15 kg的犬。对犬进行分期，并采用威斯康星大学（UW）-麦迪逊淋巴瘤方案的改良版本进行治疗。改良包括增加环磷酰胺（剂量从200 mg/m²增至250 mg/m²）和多柔比星（剂量从30 mg/m²增至37.5 mg/m²）的用量，且不交叉使用苯丁酸氮芥或甲氨蝶呤。按照方案治疗25周（17次治疗）后，停止治疗，并每月监测犬的复发情况。将无病生存期（DFI）和总生存期与55只接受UW-麦迪逊方案治疗的历史对照犬进行比较。两组在年龄、性别、品种、分期、高钙血症的存在情况和CD3状态方面具有可比性；高剂量组中更多为b期亚组犬，存在这种趋势（P = 0.076）。在比较缓解率、DFI、疾病导致的死亡和治疗相关毒性导致的死亡时，高剂量组中因毒性死亡的犬更多（P < 0.001；优势比 = 8.8）。高剂量组和对照组的总生存期在270天和318天时分别无显著差异（P = 0.55）。对于那些愿意为更短方案承担更高毒性风险且与UW-麦迪逊方案相比生存期无统计学差异的犬主来说，强化剂量方案是一种选择。
