Kawabe Mifumi, Kitajima Yuka, Murakami Mami, Iwasaki Ryota, Goto Sho, Sakai Hiroki, Mori Takashi
Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan.
Animal Medical Center, Gifu University, Gifu, Japan.
Vet Radiol Ultrasound. 2019 Jul;60(4):456-464. doi: 10.1111/vru.12754. Epub 2019 May 16.
Although lung lobectomy is the most common treatment option for dogs with solitary lung tumors, surgery often cannot be performed at the time of diagnosis. In this retrospective, case series study, we described the effects of hypofractionated radiotherapy for tumor mass reduction in nine dogs with solitary lung adenocarcinoma that were later considered for surgical resection, and we assessed the tolerability of the radiation protocol. Tumors were deemed unresectable by the attending veterinarian. The dose prescription was 7.0-12.0 Gy/fraction in four to seven fractions, administered weekly for a total dose of 40-50 Gy. Treatment planning prioritized normal tissue dose constraints. The median interval between the last radiotherapy session and maximum tumor size reduction was 56 (range: 26-196) days, with six and three dogs exhibiting a partial response and stable disease, respectively. Although acute and late radiation-induced toxicity to the skin and/or lungs developed in all nine dogs, it was self-limiting or improved with short-term anti-inflammatory treatment. Tumor progression after initial size reduction was confirmed in three dogs at 62, 126, and 175 days, respectively, after the last radiotherapy session. Seven of the nine dogs underwent lobectomy a median of 68 days after radiotherapy when tumors were in partial response or stable disease or at the time of progression, and five received systemic chemotherapy concurrent with or after radiotherapy. These findings suggest that hypofractionated radiotherapy for canine solitary lung adenocarcinoma is useful when the tumor is large or when surgery cannot be performed immediately after diagnosis.
尽管肺叶切除术是患有孤立性肺肿瘤犬类最常见的治疗选择，但在诊断时往往无法进行手术。在这项回顾性病例系列研究中，我们描述了超分割放疗对9只患有孤立性肺腺癌且后来考虑进行手术切除的犬类肿瘤体积缩小的影响，并评估了放疗方案的耐受性。主治兽医认为肿瘤无法切除。剂量处方为7.0-12.0 Gy/分次，共4至7次，每周给药一次，总剂量为40-50 Gy。治疗计划优先考虑正常组织的剂量限制。最后一次放疗疗程与最大肿瘤缩小之间的中位间隔为56天（范围：26-196天），分别有6只和3只犬出现部分缓解和病情稳定。尽管所有9只犬均出现了急性和晚期放疗引起的皮肤和/或肺部毒性，但这种毒性是自限性的，或通过短期抗炎治疗得到改善。分别在最后一次放疗疗程后的62天、126天和175天，有3只犬在最初肿瘤缩小后出现肿瘤进展。9只犬中有7只在放疗后中位68天接受了肺叶切除术，此时肿瘤处于部分缓解或病情稳定状态，或在进展时进行了手术，5只犬在放疗期间或放疗后接受了全身化疗。这些发现表明，对于犬类孤立性肺腺癌，当肿瘤较大或诊断后无法立即进行手术时，超分割放疗是有用的。
