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泼尼松龙与放射疗法治疗犬肥大细胞瘤

Treatment of canine mast cell tumours with prednisolone and radiotherapy.

作者信息

Dobson J, Cohen S, Gould S

机构信息

Queen's Veterinary School Hospital, Department of Clinical Veterinary Medicine, University of Cambridge, Cambridge, UK.

出版信息

Vet Comp Oncol. 2004 Sep;2(3):132-41. doi: 10.1111/j.1476-5810.2004.00048.x.

Abstract

This retrospective study describes 35 dogs with non-resectable, grade I-III mast cell tumours on the head or limb treated with prednisolone (40 mg m(-2) daily) for 10-14 days prior to radiotherapy (4 x 800 cGy fractions at 7-day intervals) from a 4 MV linear accelerator. Prednisolone was continued at a reduced dose rate (20 mg m(-2)) during radiotherapy and for 2 months or longer afterwards. Eighteen of 24 tumours (75%) decreased in size in response to prednisolone treatment. By 6-8 weeks following radiotherapy, 12 dogs had achieved a complete remission and 19 a partial response. Two tumours remained static and two progressed during the course of treatment. The overall response rate was 88.5%. With long-term follow-up, 11 dogs experienced local recurrence (n = 4), metastasis (n = 5) or both (n = 2). The median progression-free interval was 1031 days (95% CI 277.44-1784.56, Kaplan-Meier), with 1- and 2-year progression-free rates of 60 and 52%, respectively. Tumour grade did not predict the prognosis for this group of dogs, but tumour location did affect the outcome. Dogs with tumours located on the limb survived longer than those with tumours on the head. The combination of prednisolone with radiotherapy appears to have a useful role in the management of measurable mast cell tumours sited on the head and distal extremities.

摘要

这项回顾性研究描述了35只患有不可切除的头或四肢I-III级肥大细胞瘤的犬,在使用4兆伏直线加速器进行放射治疗(以7天间隔分4次给予800厘戈瑞剂量)之前,先用泼尼松龙(40毫克/平方米/天)治疗10-14天。在放射治疗期间,泼尼松龙以较低剂量率(20毫克/平方米)持续使用,并在之后持续2个月或更长时间。24个肿瘤中有18个(75%)对泼尼松龙治疗有反应,肿瘤大小减小。放疗后6-8周,12只犬完全缓解,19只部分缓解。在治疗过程中,2个肿瘤保持稳定,2个进展。总体缓解率为88.5%。经过长期随访,11只犬出现局部复发(n = 4)、转移(n = 5)或两者皆有(n = 2)。无进展生存期的中位数为1031天(95%置信区间277.44-1784.56,Kaplan-Meier法),1年和2年无进展率分别为60%和52%。肿瘤分级不能预测该组犬的预后,但肿瘤位置确实影响预后。四肢有肿瘤的犬比头部有肿瘤的犬存活时间更长。泼尼松龙与放疗联合似乎在治疗位于头部和远端肢体的可测量肥大细胞瘤中具有有益作用。

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