肢体骨肉瘤犬立体定向放射治疗后计算机断层扫描特征与骨折之间的关联
ASSOCIATION BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS AND FRACTURES FOLLOWING STEREOTACTIC RADIOSURGERY IN DOGS WITH APPENDICULAR OSTEOSARCOMA.
作者信息
Kubicek Lyndsay, Vanderhart Daniel, Wirth Kimberly, An Qi, Chang Myron, Farese James, Bova Francis, Sudhyadhom Atchar, Kow Kelvin, Bacon Nicholas J, Milner Rowan
机构信息
Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.
Angell Animal Medical Center, Jamaica Plain, MA, Boston, MA, 02130.
出版信息
Vet Radiol Ultrasound. 2016 May;57(3):321-30. doi: 10.1111/vru.12351. Epub 2016 Feb 25.
The objective of this observational, descriptive, retrospective study was to report CT characteristics associated with fractures following stereotactic radiosurgery in canine patients with appendicular osteosarcoma. Medical records (1999 and 2012) of dogs that had a diagnosis of appendicular osteosarcoma and undergone stereotactic radiosurgery were reviewed. Dogs were included in the study if they had undergone stereotactic radiosurgery for an aggressive bone lesion with follow-up information regarding fracture status, toxicity, and date and cause of death. Computed tomography details, staging, chemotherapy, toxicity, fracture status and survival data were recorded. Overall median survival time (MST) and fracture rates of treated dogs were calculated. CT characteristics were evaluated for association with time to fracture. Forty-six dogs met inclusion criteria. The median overall survival time was 9.7 months (95% CI: 6.9-14.3 months). The fracture-free rates at 3, 6, and 9 months were 73%, 44%, and 38% (95% CI: 60-86%, 29-60%, and 22-54%), respectively. The region of bone affected was significantly associated with time to fracture. The median time to fracture was 4.2 months in dogs with subchondral bone involvement and 16.3 months in dogs without subchondral bone involvement (P-value = 0.027, log-rank test). Acute and late skin effects were present in 58% and 16% of patients, respectively. Findings demonstrated a need for improved patient selection for this procedure, which can be aided by CT-based prognostic factors to predict the likelihood of fracture.
这项观察性、描述性、回顾性研究的目的是报告患附肢骨肉瘤的犬类患者在立体定向放射治疗后与骨折相关的CT特征。对1999年至2012年期间诊断为附肢骨肉瘤并接受立体定向放射治疗的犬类的病历进行了回顾。如果犬类因侵袭性骨病变接受了立体定向放射治疗,并具有关于骨折状态、毒性以及死亡日期和原因的随访信息,则纳入本研究。记录计算机断层扫描细节、分期、化疗、毒性、骨折状态和生存数据。计算治疗犬类的总体中位生存时间(MST)和骨折率。评估CT特征与骨折时间的相关性。46只犬符合纳入标准。总体中位生存时间为9.7个月(95%CI:6.9 - 14.3个月)。3个月、6个月和9个月时的无骨折率分别为73%、44%和38%(95%CI:60 - 86%、29 - 60%和22 - 54%)。受影响的骨区域与骨折时间显著相关。软骨下骨受累的犬类骨折中位时间为4.2个月,未受累的犬类为16.3个月(P值 = 0.027,对数秩检验)。分别有58%和16%的患者出现急性和晚期皮肤效应。研究结果表明需要改进该手术的患者选择,基于CT的预后因素有助于预测骨折可能性。