Turrel J M, Théon A P
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616.
J Am Vet Med Assoc. 1988 Aug 15;193(4):465-9.
Fifty-one cats and dogs with tumor recurrence after irradiation were treated with a second course of radiotherapy, using either teletherapy or brachytherapy. Eighty-six percent of the tumors had partial or complete response at 2 months after reirradiation. Tumor response was significantly (P = 0.041) affected when the interval between the 2 courses of irradiation was greater than 5 months. The estimated local tumor control rate was 38% at 1 year after reirradiation. Of all the factors examined, complete response at 2 months, reirradiation field size less than or equal to 10 cm2, and reirradiation dose greater than 40 gray emerged as predictors of local tumor control. The estimated overall survival rate was 47% at 2 years. Tumor location had a significant (P = 0.001) influence on overall survival; animals with cutaneous tumors had the longest survival times, and those with oral tumors had the shortest survival times. The other significant (P = 0.001) factor affecting overall survival time was the field size of the reirradiated site. Estimated survival time after reirradiation was 41% at 1 year. Favorable prognostic indicators were complete response at 2 months and location of tumor; animals with skin tumors had a favorable prognosis. The acute effects of reirradiation on normal tissues were acceptable, but 12% of the animals had severe delayed complications. Significant risk of complications after reirradiation was associated with squamous cell carcinoma (P = 0.015) and reirradiated field size greater than 30 cm2 (P = 0.056). When the interval between irradiations was greater than 5 months, the risk of complications was significantly (P = 0.022) lower.(ABSTRACT TRUNCATED AT 250 WORDS)
51只患有放疗后肿瘤复发的猫和狗接受了第二轮放射治疗,采用远距离放疗或近距离放疗。再照射后2个月,86%的肿瘤出现部分或完全缓解。当两轮照射间隔大于5个月时,肿瘤反应受到显著影响(P = 0.041)。再照射后1年的局部肿瘤控制率估计为38%。在所有检查的因素中,2个月时的完全缓解、再照射野面积小于或等于10平方厘米以及再照射剂量大于40格雷成为局部肿瘤控制的预测指标。2年时的总生存率估计为47%。肿瘤位置对总生存有显著影响(P = 0.001);皮肤肿瘤的动物生存时间最长,口腔肿瘤的动物生存时间最短。影响总生存时间的另一个显著因素(P = 0.001)是再照射部位的野面积。再照射后1年的生存时间估计为41%。良好的预后指标是2个月时的完全缓解和肿瘤位置;皮肤肿瘤的动物预后良好。再照射对正常组织的急性影响是可以接受的,但12%的动物出现严重的延迟并发症。再照射后并发症的显著风险与鳞状细胞癌(P = 0.015)和再照射野面积大于30平方厘米(P = 0.056)有关。当照射间隔大于5个月时,并发症风险显著降低(P = 0.022)。(摘要截断于250字)