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猫胸腔内顺铂化疗治疗胸膜癌病的评估:8例回顾性研究

Evaluation of intracavitary carboplatin chemotherapy for treatment of pleural carcinomatosis in cats: a retrospective study of eight cases.

作者信息

Floch Franck, Boissy Laurie, Lanore Didier, Sayag David, Serres François

机构信息

ONCOVET, Veterinary Clinic of Referrals, Villeneuve d'Ascq, France.

ALLIANCE Veterinary Clinic, Bordeaux, France.

出版信息

J Feline Med Surg. 2020 Feb;22(2):84-90. doi: 10.1177/1098612X19826401. Epub 2019 Feb 5.

Abstract

OBJECTIVES

The aim of this study was to evaluate the benefit of intracavitary carboplatin chemotherapy in cats with malignant pleural effusion of epithelial origin.

METHODS

The medical records of cats with a cytological diagnosis of neoplastic pleural effusion of epithelial origin were reviewed at three referral institutions between January 2013 and June 2018. Only cats treated with intracavitary carboplatin chemotherapy were enrolled. Data collection included signalment, medical history, clinical signs, pleural effusion analysis, diagnostic imaging findings, intracavitary carboplatin chemotherapy protocol, adverse events, response to chemotherapy, outcome and underlying primary tumour, if possible.

RESULTS

Eight cats met the inclusion criteria. Three cats had previous surgical removal of a tumour, including a poorly differentiated primary lung carcinoma, a uterine adenocarcinoma and a benign mammary tumour. The main clinical signs were tachypnoea and/or dyspnoea, inappetence and weight loss. Thoracic radiographs revealed marked bilateral pleural effusion in all cats. Pleural fluid analysis was consistent with a modified transudate, with malignant epithelial cells on cytology, leading to a diagnosis of pleural carcinomatosis. All cats received only one cycle of intracavitary carboplatin chemotherapy at a dose of 200-240 mg/m. Recurrence of pleural effusion was reported in 7/8 cats within 4-15 days of chemotherapy, and death was recorded in all cats within 5-16 days, owing to recurrent pleural effusion or poor general condition. The primary cancer was suspected to be of pulmonary, mammary and pancreatic origin in four cats, two cats and one cat, respectively, and of unknown origin in the remaining cat.

CONCLUSIONS AND RELEVANCE

In this study, intracavitary carboplatin chemotherapy seems ineffective in managing neoplastic pleural effusion of epithelial origin in cats with pleural carcinomatosis. Other cytotoxic drugs and/or techniques should be investigated in the future to improve the quality of life and survival of cats with pleural carcinomatosis.

摘要

目的

本研究的目的是评估腔内卡铂化疗对上皮源性恶性胸腔积液猫的疗效。

方法

回顾了2013年1月至2018年6月期间三家转诊机构中经细胞学诊断为上皮源性肿瘤性胸腔积液的猫的病历。仅纳入接受腔内卡铂化疗的猫。数据收集包括特征、病史、临床症状、胸腔积液分析、诊断性影像学检查结果、腔内卡铂化疗方案、不良事件、化疗反应、结局以及潜在的原发性肿瘤(如有可能)。

结果

八只猫符合纳入标准。三只猫先前接受过肿瘤手术切除,包括低分化原发性肺癌、子宫腺癌和良性乳腺肿瘤。主要临床症状为呼吸急促和/或呼吸困难、食欲不振和体重减轻。胸部X光片显示所有猫均有明显的双侧胸腔积液。胸腔积液分析与改良漏出液一致,细胞学检查发现恶性上皮细胞,从而诊断为胸膜癌转移。所有猫仅接受了一个周期的腔内卡铂化疗,剂量为200 - 240 mg/m。7/8的猫在化疗后4 - 15天内出现胸腔积液复发,所有猫在5 - 16天内死亡,原因是胸腔积液复发或全身状况不佳。分别怀疑四只猫、两只猫和一只猫的原发性癌症起源于肺、乳腺和胰腺,其余一只猫的原发性癌症起源不明。

结论及意义

在本研究中,腔内卡铂化疗似乎对患有胸膜癌转移的上皮源性肿瘤性胸腔积液猫的治疗无效。未来应研究其他细胞毒性药物和/或技术,以提高胸膜癌转移猫的生活质量和生存率。

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