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帕米膦酸盐和化疗对接受姑息性放射治疗的附肢原发性骨肿瘤犬生存时间的影响。

The impact of pamidronate and chemotherapy on survival times in dogs with appendicular primary bone tumors treated with palliative radiation therapy.

作者信息

Oblak Michelle L, Boston Sarah E, Higginson Geraldine, Patten Steven G, Monteith Gabrielle J, Woods J Paul

机构信息

Department of Clinical Studies, Ontario Veterinary College, Guelph, Canada.

出版信息

Vet Surg. 2012 Apr;41(3):430-5. doi: 10.1111/j.1532-950X.2012.00968.x.

DOI:10.1111/j.1532-950X.2012.00968.x
PMID:23253085
Abstract

OBJECTIVE

To assess survival times in dogs that received palliative radiation therapy (RT) alone, and in combination with chemotherapy, pamidronate, or both for primary appendicular bone tumors and determine whether the addition of these adjunctive therapies affects survival.

STUDY DESIGN

Retrospective case series.

ANIMALS

Dogs (n = 50) with primary appendicular bone tumors.

METHODS

Dogs were divided into the following treatment groups: RT alone, RT + chemotherapy, RT+ pamidronate, and RT+ chemotherapy + pamidronate. Dogs were considered for analysis if they had a known euthanasia date or follow-up data were available for at least 120 days from the time of diagnosis. Survival time was defined as the time from admission to euthanasia. Cox proportional hazard models and Kaplan-Meier survival functions were used. A P value of less than .05 was considered significant.

RESULTS

Fifty dogs were considered for survival analysis. Median survival times (MSTs) were longest for dogs receiving RT and chemotherapy (307 days; 95% CI: 279, 831) and shortest in dogs receiving RT and pamidronate (69 days; 95% CI: 47, 112 days). The difference in MST between dogs who received pamidronate and those who did not in this population was statistically significant in a univariate (P = .039) and multivariate analysis (P = .0015). The addition of chemotherapy into any protocol improved survival (P < .001).

CONCLUSIONS

Chemotherapy should be recommended in addition to a palliative RT protocol to improve survival of dogs with primary appendicular bone tumors. When combined with RT ± chemotherapy, pamidronate decreased MST and should not be included in a standard protocol.

摘要

目的

评估单独接受姑息性放射治疗(RT),以及联合化疗、帕米膦酸盐或两者治疗原发性四肢骨肿瘤的犬的生存时间,并确定添加这些辅助治疗是否会影响生存。

研究设计

回顾性病例系列。

动物

患有原发性四肢骨肿瘤的犬(n = 50)。

方法

将犬分为以下治疗组:单纯RT、RT + 化疗、RT + 帕米膦酸盐、RT + 化疗 + 帕米膦酸盐。如果犬有已知的安乐死日期,或者从诊断时起至少有120天的随访数据,则考虑进行分析。生存时间定义为从入院到安乐死的时间。使用Cox比例风险模型和Kaplan-Meier生存函数。P值小于0.05被认为具有统计学意义。

结果

50只犬被纳入生存分析。接受RT和化疗的犬的中位生存时间(MST)最长(307天;95%置信区间:279, 831),接受RT和帕米膦酸盐的犬最短(69天;95%置信区间:47, 112天)。在该群体中,接受帕米膦酸盐的犬和未接受帕米膦酸盐的犬之间的MST差异在单变量分析(P = 0.039)和多变量分析(P = 0.0015)中具有统计学意义。在任何方案中添加化疗均可改善生存(P < 0.001)。

结论

除了姑息性RT方案外,还应推荐化疗以提高原发性四肢骨肿瘤犬的生存率。当与RT ± 化疗联合使用时,帕米膦酸盐会降低MST,不应纳入标准方案。

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