Kelsey Krista L, Gieger Tracy L, Nolan Michael W
Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27607.
Comparative Medicine Institute, North Carolina State University College of Veterinary Medicine, Raleigh, NC, 27607.
Vet Radiol Ultrasound. 2018 Sep;59(5):632-638. doi: 10.1111/vru.12636. Epub 2018 Jun 5.
The aim of this retrospective, pilot study was to evaluate stereotactic radiosurgery as a method for treating intracranial meningiomas in dogs. Included dogs had an imaging diagnosis of presumed intracranial meningioma, were treated using a standardized stereotactic radiosurgery protocol, and had a follow-up time of >6 months after stereotactic radiosurgery. A single fraction of 16 Gy stereotactic radiosurgery was delivered to the tumor, with an internal simultaneously integrated boost to a total dose of 20-24 Gy to the central portion of the tumor. Thirty-two dogs were sampled. One dog was euthanized in the periprocedural period, and 10 of the remaining 31 dogs (31%) experienced an acute adverse event (defined as declining neurologic function due to tumor progression or treatment-associated complication within the first 6 months after stereotactic radiosurgery), three of which were fatal. Too few subjects (n = 6) had cross-sectional imaging after stereotactic radiosurgery to determine an objective response rate; however, 17/30 (57%) dogs assessed for response had a perceived clinical benefit from treatment. The overall median survival time was 519 days (95% confidence interval: 330-708 days); 64% and 24% of dogs were alive at 1 and 2 years after stereotactic radiosurgery, respectively. Dogs with infratentorial tumor location and high gradient indices had shorter survival. There were no factors identified which were predictive of acute adverse event. Survival times reported herein are similar to what has previously been reported for other stereotactic and traditional fractionated radiotherapy protocols. Findings therefore supported the use of stereotactic radiosurgery as an alternative method for treating dogs with presumed intracranial meningiomas.
这项回顾性试点研究的目的是评估立体定向放射外科手术作为治疗犬颅内脑膜瘤的一种方法。纳入的犬只经影像学诊断为疑似颅内脑膜瘤,采用标准化的立体定向放射外科手术方案进行治疗,且在立体定向放射外科手术后有超过6个月的随访时间。对肿瘤给予单次16 Gy的立体定向放射外科手术剂量,并对肿瘤中心部分进行内部同步整合加量,使总剂量达到20 - 24 Gy。共对32只犬进行了采样。1只犬在围手术期实施了安乐死,其余31只犬中有10只(31%)经历了急性不良事件(定义为在立体定向放射外科手术后的前6个月内,由于肿瘤进展或治疗相关并发症导致神经功能下降),其中3例是致命的。立体定向放射外科手术后进行横断面成像以确定客观缓解率的受试者太少(n = 6);然而,在评估反应的30只犬中,有17只(57%)从治疗中获得了明显的临床益处。总体中位生存时间为519天(95%置信区间:330 - 708天);立体定向放射外科手术后1年和2年时,分别有64%和24%的犬存活。幕下肿瘤位置且梯度指数高的犬生存时间较短。未发现可预测急性不良事件的因素。本文报告的生存时间与先前报道的其他立体定向和传统分割放疗方案的生存时间相似。因此,研究结果支持将立体定向放射外科手术作为治疗疑似颅内脑膜瘤犬的一种替代方法。