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基于直线加速器的立体定向放射治疗犬非淋巴瘤性鼻腔肿瘤:29 例病例报告(2013-2016 年)。

Linac-based stereotactic radiation therapy for canine non-lymphomatous nasal tumours: 29 cases (2013-2016).

机构信息

Department of Clinical Sciences and Comparative Medicine Institute, North Carolina State University College of Veterinary Medicine, Raleigh, North Caroline.

出版信息

Vet Comp Oncol. 2018 Mar;16(1):E68-E75. doi: 10.1111/vco.12334. Epub 2017 Jul 25.

DOI:10.1111/vco.12334
PMID:28741887
Abstract

Twenty-nine dogs were treated with linac-based stereotactic radiation therapy (SRT) for non-lymphomatous nasal tumours. Only dogs with a follow-up time >365 days were included in this retrospective analysis. No dogs had evidence of distant metastasis at diagnosis. Treatment was planned and a total of 30 Gy in 3 daily 10 Gy fractions was delivered using intensity-modulation, cone-beam CT-based image guidance and a robotic treatment couch. Clinical signs improved in all cases. Nineteen dogs had CT scans 3-4 months post-SRT and all had partial or complete tumour response. Minimal acute toxicities were detected. Clinically significant late toxicities included oronasal or nasocutaneous fistulas (N = 3) and biopsy-confirmed fungal rhinitis with no evidence of tumour progression (N = 2). The median progression-free survival (PFS) was 354 days, with 49% and 39% progression-free at 1 and 2 years post-SRT, respectively. The median survival time (ST) was 586 days, with 69% and 22% alive 1 and 2 years post-SRT, respectively. Neither the clinical parameters evaluated (modified Adams' stage, histopathology, presence of intracranial extension of the tumour) nor dosimetric data were predictive for PFS or ST. This SRT protocol appears to be well tolerated, and PFI and ST are comparable or superior to those reported in other definitive-intent radiotherapy protocols.

摘要

29 只狗接受了基于直线加速器的立体定向放射治疗(SRT)治疗非淋巴瘤性鼻腔肿瘤。只有随访时间>365 天的狗才被纳入本回顾性分析。所有狗在诊断时均无远处转移的证据。治疗计划采用调强,基于锥形束 CT 的图像引导和机器人治疗床,共 3 天内给予 30Gy,每天 10Gy。所有病例的临床症状均改善。19 只狗在 SRT 后 3-4 个月进行 CT 扫描,所有狗均有部分或完全肿瘤反应。仅检测到轻微的急性毒性。临床意义上的晚期毒性包括口鼻或鼻皮瘘(N=3)和经活检证实的真菌性鼻炎,无肿瘤进展证据(N=2)。无进展生存期(PFS)的中位数为 354 天,SRT 后 1 年和 2 年的无进展率分别为 49%和 39%。中位总生存期(ST)为 586 天,SRT 后 1 年和 2 年的存活率分别为 69%和 22%。评估的临床参数(改良的 Adams 分期、组织病理学、肿瘤颅内延伸的存在)和剂量学数据均不能预测 PFS 或 ST。该 SRT 方案似乎具有良好的耐受性,局部无进展率和总生存率与其他根治性放疗方案报告的相似或更高。

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