Wendelburg Kristin M, Price Lori Lyn, Burgess Kristine E, Lyons Jeremiah A, Lew Felicia H, Berg John
J Am Vet Med Assoc. 2015 Aug 15;247(4):393-403. doi: 10.2460/javma.247.4.393.
To determine survival time for dogs with splenic hemangiosarcoma treated with splenectomy alone, identify potential prognostic factors, and evaluate the efficacy of adjuvant chemotherapy.
Retrospective case series.
208 dogs.
Medical records were reviewed, long-term follow-up information was obtained, and survival data were analyzed statistically.
154 dogs were treated with surgery alone, and 54 were treated with surgery and chemotherapy. Twenty-eight dogs received conventional chemotherapy, 13 received cyclophosphamide-based metronomic chemotherapy, and 13 received both conventional and metronomic chemotherapy. Median survival time of dogs treated with splenectomy alone was 1.6 months. Clinical stage was the only prognostic factor significantly associated with survival time. When the entire follow-up period was considered, there was no significant difference in survival time between dogs treated with surgery alone and dogs treated with surgery and chemotherapy. However, during the first 4 months of follow-up, after adjusting for the effects of clinical stage, survival time was significantly prolonged among dogs receiving any type of chemotherapy (hazard ratio, 0.6) and among dogs receiving both conventional and metronomic chemotherapy (hazard ratio, 0.4).
Clinical stage was strongly associated with prognosis for dogs with splenic hemangiosarcoma. Chemotherapy was effective in prolonging survival time during the early portion of the follow-up period. Combinations of doxorubicin-based conventional protocols and cyclophosphamide-based metronomic protocols appeared to be more effective than either type of chemotherapy alone, but prolongations in survival time resulting from current protocols were modest.
确定仅接受脾切除术治疗的脾血管肉瘤犬的生存时间,识别潜在的预后因素,并评估辅助化疗的疗效。
回顾性病例系列研究。
208只犬。
查阅病历,获取长期随访信息,并对生存数据进行统计学分析。
154只犬仅接受手术治疗,54只犬接受手术和化疗。28只犬接受传统化疗,13只犬接受基于环磷酰胺的节拍化疗,13只犬同时接受传统化疗和节拍化疗。仅接受脾切除术治疗的犬的中位生存时间为1.6个月。临床分期是与生存时间显著相关的唯一预后因素。当考虑整个随访期时,仅接受手术治疗的犬和接受手术及化疗的犬的生存时间无显著差异。然而,在随访的前4个月,在调整临床分期的影响后,接受任何类型化疗的犬(风险比,0.6)以及同时接受传统化疗和节拍化疗的犬(风险比,0.4)的生存时间显著延长。
临床分期与脾血管肉瘤犬的预后密切相关。化疗在随访早期有效延长了生存时间。基于阿霉素的传统方案与基于环磷酰胺的节拍方案联合使用似乎比单独使用任何一种化疗更有效,但目前方案导致的生存时间延长幅度不大。