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无框架立体定向放射治疗疑似犬颅内胶质瘤的疗效:回顾性分析(2014-2017 年)。

Efficacy of frameless stereotactic radiotherapy for the treatment of presumptive canine intracranial gliomas: A retrospective analysis (2014-2017).

机构信息

General Medicine and Surgery, The Animal Medical Center, New York City, New York.

Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, New York.

出版信息

Vet Comp Oncol. 2020 Dec;18(4):528-537. doi: 10.1111/vco.12573. Epub 2020 Apr 23.

Abstract

The use of conventional multi-fractionated radiotherapy for the treatment of glial tumours is well documented in the literature. Recently, stereotactic radiotherapy (SRT) has become more widely available allowing for hypo-fractionated protocols; however, its usefulness in the treatment of canine intracranial gliomas is largely undetermined. We conducted a retrospective analysis, including 21 dogs diagnosed with presumptive intracranial gliomas treated with one or more courses of three fractions of 8 to 10 Gy CyberKnife SRT. The objective of this study was to evaluate the efficacy, safety and prognostic factors associated with the use of SRT for the treatment of canine intracranial gliomas. Overall MST for all dogs was 636 days (d). Dogs treated with one course of the described SRT protocol had a MST of 258 days while those treated with >1 course had a MST of 865 days (P = .0077 log rank, 0.0139 Wilcoxon). Dogs treated with one course of SRT who received adjuvant chemotherapy had a MST of >658 days and lived significantly longer than those who did not receive chemotherapy (MST, 230 days) (P = .0414 log rank, 0.0453 Wilcoxon). The most common adverse event included presumptive transient demyelination in 3/21 dogs, which was treated successfully with corticosteroids in all patients. This study provides evidence that SRT is effective in prolonging survival in dogs with intracranial gliomas, and may provide similar results to conventional fractionated protocols, while decreasing the number of hospital visits and anaesthetic episodes. Additionally, it appears that patients can be safely treated with multiple rounds of SRT resulting in improved survival times.

摘要

常规多分割放射疗法治疗神经胶质瘤的文献已有大量记载。最近,立体定向放射疗法(SRT)的应用越来越广泛,允许采用低分割方案;然而,其在治疗犬颅内神经胶质瘤方面的效用在很大程度上仍未确定。我们进行了一项回顾性分析,纳入了 21 只接受过一次或多次 8 至 10Gy CyberKnife SRT 三分割治疗的疑似颅内神经胶质瘤犬。本研究的目的是评估 SRT 治疗犬颅内神经胶质瘤的疗效、安全性和相关预后因素。所有犬的总生存期(MST)为 636 天(d)。接受一次描述性 SRT 方案治疗的犬 MST 为 258 天,而接受>1 次治疗的犬 MST 为 865 天(P=.0077 对数秩检验,0.0139 Wilcoxon 检验)。接受一次 SRT 治疗并接受辅助化疗的犬 MST 超过 658 天,比未接受化疗的犬存活时间显著延长(MST 为 230 天)(P=.0414 对数秩检验,0.0453 Wilcoxon 检验)。最常见的不良事件包括 3/21 只犬出现疑似短暂脱髓鞘,所有患者均经皮质类固醇成功治疗。本研究提供了证据表明 SRT 可有效延长颅内神经胶质瘤犬的生存时间,并且可能与常规分割方案产生相似的结果,同时减少就诊次数和麻醉次数。此外,似乎可以安全地对患者进行多次 SRT 治疗,从而延长生存时间。

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