Fox-Alvarez Stacey, Shiomitsu Keijiro, Lejeune Amandine T, Szivek Anna, Kubicek Lyndsay
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
Angell Animal Medical Center, Boston, Massachusetts.
Vet Radiol Ultrasound. 2020 May;61(3):370-378. doi: 10.1111/vru.12854. Epub 2020 Mar 18.
Stereotactic radiation therapy (SRT) has emerged as a convenient definitive treatment modality in veterinary medicine, but few studies exist evaluating outcome with treatment for canine nasal tumors, and no studies report the treatment of one single tumor histotype. This retrospective, observational study evaluates toxicity, response, and survival in 17 dogs with nasal carcinomas treated with SRT. Dogs received a median of 3000 centigray in three fractions via 6-MV linear accelerator. Eighty-eight percent of patients (n = 15) demonstrated clinical benefit. Of dogs with repeated CT imaging (n = 10), 60% (n = 6) achieved a partial response and 10% (n = 1) achieved a complete response. Median progression-free survival (PFS) was 359 days. Median survival time (MST) was 563 days. Among dogs evaluable for acute toxicity, 50% (n = 10) developed low grade toxicity (grade 1, n = 4; grade 2, n = 1). No patients developed grade 3 toxicity. 16 dogs (87%) evaluable over the long term developed signs consistent with possible late toxicity. The majority of late toxicities were mild (alopecia, hyperpigmentation, and leukotrichia n = 10; ocular discharge and keratoconjunctivitis sicca n = 5). Thirty-seven percent of patients (n = 6) developed seven possible grade 3 late toxicities (blindness, n = 3; fistula, n = 1; seizures, n = 3), which were difficult to distinguish from progressive disease in most patients. Of the prognostic factors evaluated (demographics, tumor stage, dosimetric data, epistaxis, facial deformity, clinical response, image-based response, nonsteroidal anti-inflammatory drugs, and chemotherapy), only clinical response was a positive prognostic factor on MST (P < .00). No factors were found to be significantly associated with PFS.
立体定向放射治疗（SRT）已成为兽医学中一种便捷的确定性治疗方式，但评估犬鼻肿瘤治疗效果的研究较少，且尚无研究报道单一肿瘤组织学类型的治疗情况。这项回顾性观察研究评估了17只接受SRT治疗的鼻癌犬的毒性、反应和生存情况。犬通过6兆伏直线加速器分三次接受中位剂量为3000厘戈瑞的照射。88%（n = 15）的患者显示出临床获益。在接受重复CT成像的犬（n = 10）中，60%（n = 6）达到部分缓解，10%（n = 1）达到完全缓解。中位无进展生存期（PFS）为359天。中位生存时间（MST）为563天。在可评估急性毒性的犬中，50%（n = 10）出现低级别毒性（1级，n = 4；2级，n = 1）。无患者出现3级毒性。16只（87%）可长期评估的犬出现了与可能的晚期毒性一致的体征。大多数晚期毒性较轻（脱发、色素沉着和白毛，n = 10；眼部分泌物和干眼症，n = 5）。37%（n = 6）的患者出现了七种可能的3级晚期毒性（失明，n = 3；瘘管，n = 1；癫痫发作，n = 3），在大多数患者中难以与疾病进展区分开来。在所评估的预后因素（人口统计学、肿瘤分期、剂量学数据、鼻出血、面部畸形、临床反应、基于图像的反应、非甾体抗炎药和化疗）中，只有临床反应是MST的阳性预后因素（P <.00）。未发现与PFS显著相关的因素。
