Demetriou J L, Brearley M J, Constantino-Casas F, Addington C, Dobson J
Queens Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, Cambridgeshire CB3 0ES.
J Small Anim Pract. 2012 Mar;53(3):174-81. doi: 10.1111/j.1748-5827.2011.01186.x.
To evaluate the outcome in a group of dogs treated with postoperative radiotherapy following intentional marginal excision of soft tissue sarcomas from their limbs and to assess parameters for prognostic significance.
Patients that had had intentional marginal excision of limb soft tissue sarcomas followed by radiotherapy were selected. A coarse fractionated protocol of four once weekly 8 to 9 Gy by 4 MV x-rays was used. The time to local recurrence was determined. Tumour grade, size, site, number of surgeries, surgeon and time from last surgery to radiotherapy were evaluated as potential prognostic indicators.
Fifty-six cases were included. Minor surgical complications occurred in four patients (7%). Tumour recurred locally in 10 dogs (18%). Fourteen dogs died from tumour-related causes (25%). From Cox proportional hazard analysis time from surgery to radiotherapy was the only predictor of tumour recurrence (P=0·039); hazard ratio 8·63. Delaying radiotherapy beyond 4 weeks was associated with improved outcomes. Three dogs developed serious but non-life-threatening local complications; wound dehiscence, self-trauma and osteonecrosis of underlying bone.
Intentional marginal excision followed by hypofractionated radiotherapy is a viable option for canine limb soft tissue sarcomas, providing good long-term clinical outcomes and low morbidity.
评估一组犬在肢体软组织肉瘤进行意向性边缘切除术后接受术后放疗的结果，并评估具有预后意义的参数。
选择接受了肢体软组织肉瘤意向性边缘切除并随后进行放疗的患者。采用4MV X射线每周一次、每次8至9Gy的粗分割方案。确定局部复发时间。评估肿瘤分级、大小、部位、手术次数、外科医生以及从最后一次手术到放疗的时间作为潜在的预后指标。
纳入56例病例。4例患者（7%）出现轻微手术并发症。10只犬（18%）出现局部肿瘤复发。14只犬死于肿瘤相关原因（25%）。通过Cox比例风险分析，从手术到放疗的时间是肿瘤复发的唯一预测因素（P = 0·039）；风险比为8·63。放疗延迟超过4周与预后改善相关。3只犬出现严重但不危及生命的局部并发症；伤口裂开、自我创伤和深层骨坏死。
意向性边缘切除后进行低分割放疗是犬肢体软组织肉瘤的一种可行选择，可提供良好的长期临床结果且发病率低。
