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口服洛莫司汀治疗疑似颅内胶质瘤犬的生存时间:一项比较性回顾性研究(2008 - 2017年)

Survival times in dogs with presumptive intracranial gliomas treated with oral lomustine: A comparative retrospective study (2008-2017).

作者信息

Moirano S J, Dewey C W, Wright K Z, Cohen P W

机构信息

College of Veterinary Medicine, Cornell University, Ithaca, New York.

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.

出版信息

Vet Comp Oncol. 2018 Dec;16(4):459-466. doi: 10.1111/vco.12401. Epub 2018 May 24.

Abstract

Intracranial gliomas are a common malignancy in dogs, and are associated with a poor prognosis due to their aggressive nature and a lack of clinically effective treatments. The efficacies of various treatment modalities for canine brain tumours have been previously described, though little data exist on the use of cytotoxic chemotherapy. A comparative retrospective study, including 40 cases from 5 northeastern US veterinary hospitals, from 2008 to 2017, was conducted. Variables analysed in this study with relation to overall survival and prognostic significance included: age, sex, clinical signs, clinical sign duration, tumour location and treatment protocol used. Dogs with presumptive intracranial gliomas treated with lomustine chemotherapy lived longer (median, 138 days) than those treated exclusively with symptomatic care (median, 35 days; P = .0026 log-rank, 0.0138 Wilcoxon). Additionally, a duration of clinical signs ≥16 days prior to diagnosis (median, 109 days) was associated with a longer survival than a duration <16 days prior (median, 25 days; P = .0100 log-rank, 0.0322 Wilcoxon). Lomustine-associated side effects included neutropenia in 46% of dogs, anaemia in 15% and thrombocytopenia in 15%. Potential renal and hepatotoxicity based on increased BUN and/or creatinine and ALT values were reported in 15% and 50% of dogs, respectively. This study provides evidence that lomustine therapy may be effective in prolonging survival in dogs with intracranial gliomas and should be considered as a potential treatment option. Although lomustine-related toxicities are fairly common, they are rarely life threatening and often do not result in discontinuation of therapy.

摘要

颅内胶质瘤是犬类常见的恶性肿瘤,由于其侵袭性本质和缺乏临床有效治疗方法,预后较差。先前已经描述了各种治疗方式对犬脑肿瘤的疗效,不过关于细胞毒性化疗的使用数据很少。进行了一项回顾性比较研究,纳入了2008年至2017年美国东北部5家兽医医院的40例病例。本研究中分析的与总生存期和预后意义相关的变量包括:年龄、性别、临床症状、临床症状持续时间、肿瘤位置和使用的治疗方案。接受洛莫司汀化疗的疑似颅内胶质瘤犬的生存期更长(中位数为138天),而仅接受对症治疗的犬生存期较短(中位数为35天;对数秩检验P = 0.0026,Wilcoxon检验P = 0.0138)。此外,诊断前临床症状持续时间≥16天(中位数为109天)的犬比临床症状持续时间<16天(中位数为25天)的犬生存期更长(对数秩检验P = 0.0100,Wilcoxon检验P = 0.0322)。洛莫司汀相关的副作用包括46%的犬出现中性粒细胞减少、15%的犬出现贫血、15%的犬出现血小板减少。分别有15%和50%的犬报告基于血尿素氮和/或肌酐及谷丙转氨酶值升高的潜在肾毒性和肝毒性。本研究提供了证据表明洛莫司汀治疗可能有效延长颅内胶质瘤犬的生存期,应被视为一种潜在的治疗选择。虽然洛莫司汀相关的毒性相当常见,但很少危及生命,且通常不会导致治疗中断。

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