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犬侵袭性恶性乳腺肿瘤手术切除后使用吉西他滨辅助治疗。

Adjuvant gemcitabine after surgical removal of aggressive malignant mammary tumours in dogs.

作者信息

Marconato L, Lorenzo R M, Abramo F, Ratto A, Zini E

机构信息

Clinica Veterinaria L'Arca, Naples, Italy.

出版信息

Vet Comp Oncol. 2008 Jun;6(2):90-101. doi: 10.1111/j.1476-5829.2007.00143.x.

Abstract

Canine mammary tumours are generally treated with surgery alone, despite the fact that 50% of them are malignant and many will eventually lead to recurrence or metastases. A prospective clinical trial in which dogs with aggressive mammary carcinoma of clinical stages IV and V were treated with surgical excision (n = 9) or with surgery and adjuvant weekly gemcitabine (n = 10) for at least four cycles was conducted. Gemcitabine was given as an intravenous infusion at the dose of 800 mg m(-2). Aim of the study was to explore potential beneficial effects of gemcitabine on time to local recurrence (TTR), time to distant metastases (TTM) and overall survival (OS) in canine patients with operated mammary tumours bearing high risk for locoregional failure and distant metastases. Also, factors associated with OS, including neutering status, body weight, age, clinical stage at presentation, tumour size, histological grade and, in dogs receiving chemotherapy, the number of gemcitabine treatments, were investigated. Finally, acute toxicities related to chemotherapy and quality of life were assessed in dogs receiving gemcitabine. Dogs treated with surgery alone or surgery followed by gemcitabine had no difference in TTR, TTM or OS (P > 0.05). In the group of dogs receiving adjuvant chemotherapy, the number of gemcitabine treatments was positively correlated with OS (P = 0.017). Gemcitabine treatment was well tolerated, with no dogs experiencing clinically relevant haematological or gastrointestinal toxicity. Despite being safe at the present dose, gemcitabine chemotherapy as an adjunct treatment to surgical excision may not be recommended in dogs with aggressive mammary carcinoma.

摘要

犬乳腺肿瘤通常仅采用手术治疗,尽管其中50%为恶性,且许多最终会导致复发或转移。开展了一项前瞻性临床试验,对临床分期为IV期和V期的侵袭性乳腺癌犬,一组(n = 9)采用手术切除治疗,另一组(n = 10)采用手术切除并辅助每周使用吉西他滨治疗,至少进行四个周期。吉西他滨以800 mg m(-2)的剂量静脉输注。该研究的目的是探讨吉西他滨对接受手术的乳腺肿瘤犬局部复发时间(TTR)、远处转移时间(TTM)和总生存期(OS)的潜在有益影响,这些犬存在局部区域失败和远处转移的高风险。此外,还研究了与OS相关的因素,包括绝育状态、体重、年龄、就诊时的临床分期、肿瘤大小、组织学分级,以及接受化疗的犬中吉西他滨治疗的次数。最后,对接受吉西他滨治疗的犬评估了与化疗相关的急性毒性和生活质量。单纯手术治疗或手术加吉西他滨治疗的犬在TTR、TTM或OS方面无差异(P > 0.05)。在接受辅助化疗的犬组中,吉西他滨治疗的次数与OS呈正相关(P = 0.017)。吉西他滨治疗耐受性良好,没有犬出现临床相关的血液学或胃肠道毒性。尽管目前剂量下安全,但对于侵袭性乳腺癌犬,不建议将吉西他滨化疗作为手术切除的辅助治疗。

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