Körner Maximilian, Roos Malgorzata, Meier Valeria S, Soukup Alena, Cancedda Simona, Parys Magdalena M, Turek Michelle, Rohrer Bley Carla
1 Divison of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
2 Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, University of Zurich, Zurich, Switzerland.
J Feline Med Surg. 2019 Aug;21(8):765-771. doi: 10.1177/1098612X18801032. Epub 2018 Oct 19.
The aim of this study was to evaluate the outcome of cats with intracranial tumours presenting with neurological signs treated with radiation therapy.
This study comprised a retrospective multicentre case series. Medical records of a total of 22 cats with intracranial space-occupying lesions, presenting with neurological signs and/or epileptic seizures and treated with external beam radiation therapy, were reviewed. In the treated cats, patient-, tumour- and treatment-related variables were investigated, including age, sex, tumour location, tumour volume, total radiation dose, equivalent dose in 2 Gy fractions (EQD), corticosteroid dose, overall treatment time and institution for influence on local tumour control and survival.
Based on advanced imaging characteristics, the 22 treated cats presented with meningioma (n = 11), pituitary tumour (n = 8), choroid plexus tumour (n = 2) or glioma (n = 1). Allocated to the neuraxis, 11 lesions were extra-axial, three were intra-axial and eight were located in the pituitary region. At diagnosis, 21 cats exhibited altered neurological status. One cat presented with epileptic seizures and another cat had both seizures and altered neurological status. The mean total physical dose of radiation was 41.63 Gy (± 4.33), range 24-45 Gy. In all but one cat (95.5%), neurological signs improved after radiation therapy. The median progression-free survival was 510 days (95% confidence interval [CI]: 51-969). The proportion free of progression at 1 year was 55.7% (95% CI: 33-78). Fourteen cats died (only in five cases was death related to the intracranial tumour) and eight cats were still alive or lost to follow-up. The median overall survival time was 515 days (95% CI: 66-964). None of the tested variables influenced outcome.
Radiation therapy seems to represent a viable treatment option in cats with intracranial tumours, relieving neurological signs and improving local tumour control. Radiation therapy may be considered for cats with tumours in complicated/inoperable localisations or for cases with a high peri- and postoperative risk.
本研究旨在评估接受放射治疗的出现神经症状的颅内肿瘤猫的治疗结果。
本研究为一项回顾性多中心病例系列研究。回顾了总共22只患有颅内占位性病变、出现神经症状和/或癫痫发作并接受外照射放疗的猫的病历。在接受治疗的猫中，研究了与患者、肿瘤和治疗相关的变量，包括年龄、性别、肿瘤位置、肿瘤体积、总辐射剂量、2Gy分次等效剂量（EQD）、皮质类固醇剂量、总治疗时间以及机构对局部肿瘤控制和生存的影响。
根据先进的影像学特征，22只接受治疗的猫患有脑膜瘤（n = 11）、垂体瘤（n = 8）、脉络丛肿瘤（n = 2）或胶质瘤（n = 1）。在神经轴上，11个病变位于轴外，3个位于轴内，8个位于垂体区域。诊断时，21只猫表现出神经状态改变。1只猫出现癫痫发作，另1只猫既有癫痫发作又有神经状态改变。平均总物理辐射剂量为41.63 Gy（±4.33），范围为24 - 45 Gy。除1只猫（95.5%）外，所有猫在放疗后神经症状均有改善。无进展生存期的中位数为510天（95%置信区间[CI]：51 - 969）。1年时无进展的比例为55.7%（95% CI：33 - 78）。14只猫死亡（仅5例死亡与颅内肿瘤有关），8只猫仍存活或失访。总生存期的中位数为515天（95% CI：66 - 964）。所测试的变量均未影响治疗结果。
放射治疗似乎是患有颅内肿瘤猫的一种可行治疗选择，可缓解神经症状并改善局部肿瘤控制。对于肿瘤位于复杂/无法手术部位的猫或围手术期及术后风险高的病例，可考虑放射治疗。
