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对41只接受根治性放疗(联合或不联合化疗)治疗的高级别软组织肉瘤切除不完全的犬,评估与预后相关的变量。

Evaluation of variables associated with outcomes in 41 dogs with incompletely excised high-grade soft tissue sarcomas treated with definitive-intent radiation therapy with or without chemotherapy.

作者信息

Crownshaw Abigail H, McEntee Margaret C, Nolan Michael W, Gieger Tracy L

出版信息

J Am Vet Med Assoc. 2020 Apr 1;256(7):783-791. doi: 10.2460/javma.256.7.783.

DOI:10.2460/javma.256.7.783
PMID:32176583
Abstract

OBJECTIVE

To evaluate potential prognostic indicators for local recurrence, distant metastasis, and survival time in dogs with incompletely excised high-grade soft tissue sarcomas (HGSTSs), as defined by a mitotic index ≥ 9, that underwent definitive-intent radiation treatment (RT; ≥ 48 Gy total dose) with or without adjuvant chemotherapy.

ANIMALS

41 client-owned dogs with HGSTSs treated with surgical resection followed by definitive-intent RT between January 1, 2000, and December 31, 2016.

PROCEDURES

Medical records were reviewed retrospectively, and data were collected. The Kaplan-Meier method was used to evaluate the overall survival time (OST) of dogs and time to progression (TTP) of disease, starting from the first day of RT. The Cox proportional hazards model was used to analyze the impact of results for several variables on OST and TTP.

RESULTS

The median OST was 981 days, with 1-, 3-, and 5-year survival rates of 85%, 43%, and 18%, respectively. The median TTP was not reached; however, the mean TTP was 1,581 days. Ten of the 41 (24%) dogs developed metastasis, and 8 (20%) developed local recurrence. Sixteen of the 41 dogs received chemotherapy. The hazard of disease progression over the study period increased as the mitotic index (hazard ratio [HR], 1.115) or duration of RT (HR, 1.427) increased. The hazard of death over the study period increased as the RT duration (HR, 1.372) or surgical scar length (HR, 1.272) increased.

CONCLUSIONS AND CLINICAL RELEVANCE

Although adjuvant chemotherapy was not associated with improved survival time in dogs of the present study, results indicated that improved OST and TTP could be achieved through strict adherence to the prescribed irradiation schedule and avoidance of unnecessary prolongation of the course of RT.

摘要

目的

评估接受根治性放疗(总剂量≥48 Gy)联合或不联合辅助化疗的、有丝分裂指数≥9定义的不完全切除的高级别软组织肉瘤(HGSTS)犬局部复发、远处转移和生存时间的潜在预后指标。

动物

2000年1月1日至2016年12月31日期间,41只接受手术切除后进行根治性放疗的客户拥有的HGSTS犬。

程序

对病历进行回顾性审查并收集数据。采用Kaplan-Meier法评估犬的总生存时间(OST)和疾病进展时间(TTP),从放疗第一天开始计算。采用Cox比例风险模型分析多个变量结果对OST和TTP的影响。

结果

中位OST为981天,1年、3年和5年生存率分别为85%、43%和18%。未达到中位TTP;然而,平均TTP为1581天。41只犬中有10只(24%)发生转移,8只(20%)发生局部复发。41只犬中有16只接受了化疗。随着有丝分裂指数(风险比[HR],1.115)或放疗持续时间(HR,l.427)增加,研究期间疾病进展风险增加。随着放疗持续时间(HR,1.372)或手术瘢痕长度(HR,1.272)增加,研究期间死亡风险增加。

结论及临床意义

尽管本研究中辅助化疗与犬生存时间改善无关,但结果表明,通过严格遵守规定的照射方案并避免不必要地延长放疗疗程,可改善OST和TTP。

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