Nolan M W, Arkans M M, LaVine D, DeFrancesco T, Myers J A, Griffith E H, Posner L P, Keene B W, Tou S P, Gieger T L
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA; Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA.
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA; MedVet Chicago, 3130 N. Clybourn Ave., Chicago, IL, 60618, USA.
J Vet Cardiol. 2017 Apr;19(2):132-143. doi: 10.1016/j.jvc.2016.12.001. Epub 2017 Mar 7.
To determine the short-term safety and biologic activity of radiation therapy (RT) for presumptive cardiac hemangiosarcoma in pet dogs.
Six dogs with echocardiographic evidence of a right atrial/auricular mass, and hemorrhagic pericardial effusion, were enrolled in a prospective, single-arm clinical trial.
A single fraction of 12 Gy was delivered using conformal external beam irradiation. Serum cardiac troponin I and plasma concentrations of vascular endothelial growth factor were quantified before, 4 and 24 h after RT. The frequency of required pericardiocenteses (quantified as the number of pericardiocenteses per week) before RT was compared to that after treatment. Overall survival time was determined.
No treatment-related complications were observed. Pericardiocentesis was performed an average of 0.91 times per week before RT, and an average of 0.21 times per week after RT; this difference was statistically significant (p=0.03, as compared using a Wilcoxon signed-rank test of paired data). Pre- and post-treatment plasma vascular endothelial growth factor concentrations were not significantly different at any time point; there was a statistically significant (p=0.04; Friedman's test for non-parametric repeated measures) increase in cardiac troponin concentrations 4 h after irradiation. Median overall survival time was 79 days.
In this population of dogs, RT was delivered without complication, and appears to have reduced the frequency of periacardial tamponade that necessitated pericardiocentesis. Serum cardiac troponin levels are altered after RT. RT alone, or in combination with chemotherapy, may provide clinical benefit to dogs with presumptive diagnoses of cardiac hemangiosarcoma.
确定放射治疗（RT）对疑似患有心脏血管肉瘤的宠物狗的短期安全性和生物学活性。
六只经超声心动图证实有右心房/心耳肿块及出血性心包积液的狗被纳入一项前瞻性单臂临床试验。
采用适形外照射给予单次12 Gy剂量。在放疗前、放疗后4小时和24小时对血清心肌肌钙蛋白I和血管内皮生长因子的血浆浓度进行定量。比较放疗前所需心包穿刺术的频率（以每周心包穿刺术的次数来量化）与治疗后的频率。确定总生存时间。
未观察到与治疗相关的并发症。放疗前平均每周进行0.91次心包穿刺术，放疗后平均每周进行0.21次；这种差异具有统计学意义（p = 0.03，使用配对数据的Wilcoxon符号秩检验进行比较）。治疗前后血浆血管内皮生长因子浓度在任何时间点均无显著差异；放疗后4小时心肌肌钙蛋白浓度有统计学意义的升高（p = 0.04；Friedman非参数重复测量检验）。中位总生存时间为79天。
在这群狗中，放疗未出现并发症，且似乎降低了需要进行心包穿刺术的心包填塞频率。放疗后血清心肌肌钙蛋白水平发生改变。单独放疗或与化疗联合使用，可能对疑似患有心脏血管肉瘤的狗提供临床益处。
