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接受姑息治疗的原发性脑肿瘤犬出院后的生存时间。

Survival time following hospital discharge in dogs with palliatively treated primary brain tumors.

作者信息

Rossmeisl John H, Jones Jeryl C, Zimmerman Kurt L, Robertson John L

机构信息

Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA.

出版信息

J Am Vet Med Assoc. 2013 Jan 15;242(2):193-8. doi: 10.2460/javma.242.2.193.

Abstract

OBJECTIVE

To analyze survival time and identify prognostic factors associated with outcome following discharge in dogs with primary brain tumors treated palliatively.

DESIGN

Prospective case series.

ANIMALS

51 dogs with 5 histopathologic types of brain tumors.

PROCEDURES

Owners with dogs examined from 2004 to 2008 were invited to participate if dogs had CT or MRI evidence of a brain mass that was histopathologically confirmed as a neoplasm upon death, dogs survived for ≥ 48 hours after hospital discharge, and treatments following discharge were limited to administration of prednisone or phenobarbital. Prognostic factors, including signalment, clinical signs (including duration), tumor type, tumor location, degree of peritumoral edema, lesion burden, and prescribed treatment, were evaluated. Survival time was estimated and animal- and tumor-specific variables evaluated as potential prognostic factors.

RESULTS

The median survival time in all dogs was 69 days (95% confidence interval [CI], 18 to 201 days). Multivariate analyses identified neuroanatomic location as the only significant prognostic variable, with the survival time of dogs with infratentorial tumors (n = 18) being significantly shorter (median, 28 days; 95% CI, 19 to 68 days) than survival time of dogs with supratentorial (33) tumors (median, 178 days; 95% CI, 119 to 270 days). Seizures were the most common clinical sign associated with supratentorial tumors (24/33 [73%]) and central vestibular dysfunction with infratentorial tumors (12/18).

CONCLUSIONS AND CLINICAL RELEVANCE

Dogs with palliatively treated primary brain tumors, particularly those with tumors in the cerebellum, pons, or medulla, had a poor prognosis. However, dogs with supratentorial tumors had survival times > 3 months.

摘要

目的

分析接受姑息治疗的原发性脑肿瘤犬只出院后的生存时间,并确定与预后相关的因素。

设计

前瞻性病例系列研究。

动物

51只患有5种组织病理学类型脑肿瘤的犬只。

方法

邀请2004年至2008年期间接受检查的犬只的主人参与研究,条件为犬只经CT或MRI检查有脑肿块证据,且在死后经组织病理学确诊为肿瘤,犬只出院后存活≥48小时,出院后的治疗仅限于给予泼尼松或苯巴比妥。评估预后因素,包括特征、临床症状(包括持续时间)、肿瘤类型、肿瘤位置、肿瘤周围水肿程度、病变负荷和规定的治疗。估计生存时间,并将动物和肿瘤特异性变量评估为潜在的预后因素。

结果

所有犬只的中位生存时间为69天(95%置信区间[CI],18至201天)。多变量分析确定神经解剖位置是唯一显著的预后变量,幕下肿瘤(n = 18)犬只的生存时间(中位值,28天;95% CI,19至68天)明显短于幕上肿瘤(33只)犬只的生存时间(中位值,178天;95% CI,119至270天)。癫痫发作是幕上肿瘤最常见的临床症状(24/33 [73%]),而中枢前庭功能障碍是幕下肿瘤最常见的临床症状(12/18)。

结论及临床意义

接受姑息治疗的原发性脑肿瘤犬只,尤其是小脑、脑桥或延髓有肿瘤的犬只,预后较差。然而,幕上肿瘤犬只的生存时间>3个月。

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