Schwarz Philip, Meier Valeria, Soukup Alena, Drees Randi, Besserer Jürgen, Beckmann Katrin, Roos Malgorzata, Rohrer Bley Carla
Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
QMHA Diagnostic Imaging, The Royal Veterinary College, Hertfordshire, United Kingdom.
J Vet Intern Med. 2018 Nov;32(6):2013-2020. doi: 10.1111/jvim.15324. Epub 2018 Oct 11.
Use of strongly hypofractionated radiation treatments in dogs with intracranial neoplasia did not improve outcomes and yielded increased rates of toxicosis.
To evaluate safety and efficacy of a new, moderately hypofractionated radiation protocol of 10 × 4 Gy compared to a standard protocol.
Convenience sample of 56 client-owned dogs with primary symptomatic brain tumors.
Retrospective observational study. Twenty-six dogs were assigned to the control standard protocol of 20 × 2.5 Gy (group A) and 30 dogs to the new protocol of 10 × 4 Gy (group B), assigned on owners' informed consent. Statistical analysis was conducted under the "as treated" regime, using Kaplan-Meier and Cox-regression analysis. Treatment was delivered with technically advanced image-guided radiation therapy. The 2 treatment groups were compared in terms of outcome and signs of toxicosis.
Overall progression-free interval (PFI) and overall survival (OS) time were favorable, with 663 (95%CI: 497;828) and 637 (95%CI: 403;870) days, respectively. We found no significant difference between the two groups: PFI for dogs in group A vs B was 608 (95%CI: 437;779) days and mean (median not reached) 863 (95%CI: 644;1083) days, respectively (P = .89), and OS for dogs in group A vs B 610 (95%CI: 404;816) and mean (median not reached) 796 (95%CI: 586;1007) days (P = .83).
In conclusion, 10 × 4 Gy is a safe and efficient protocol for treatment of primary intracranial neoplasia and future dose escalation can be considered.
在患有颅内肿瘤的犬只中使用高度超分割放射治疗并不能改善治疗效果,反而会增加中毒发生率。
与标准方案相比,评估一种新的10×4 Gy中度超分割放射方案的安全性和有效性。
56只患有原发性症状性脑肿瘤的客户拥有犬只的便利样本。
回顾性观察研究。26只犬被分配到20×2.5 Gy的对照标准方案(A组),30只犬被分配到10×4 Gy的新方案(B组),分配基于主人的知情同意。在“按治疗情况”方案下进行统计分析,使用Kaplan-Meier和Cox回归分析。采用技术先进的图像引导放射治疗进行治疗。比较两个治疗组的治疗效果和中毒体征。
总体无进展生存期(PFI)和总生存期(OS)时间良好,分别为663(95%CI:497;828)天和637(95%CI:403;870)天。我们发现两组之间无显著差异:A组犬的PFI为608(95%CI:437;779)天,B组犬的PFI平均(未达到中位数)为863(95%CI:644;1083)天(P = 0.89);A组犬的OS为610(95%CI:404;816)天,B组犬的OS平均(未达到中位数)为796(95%CI:586;1007)天(P = 0.83)。
总之,10×4 Gy是治疗原发性颅内肿瘤的一种安全有效的方案,未来可考虑增加剂量。