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应用非甾体类抗炎药、米托蒽醌和放射疗法治疗犬泌尿生殖系统癌:一项回顾性研究。

Treatment of genitourinary carcinoma in dogs using nonsteroidal anti-inflammatory drugs, mitoxantrone, and radiation therapy: A retrospective study.

机构信息

Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA.

Veterinary Referral Associates, Gaithersburg, Maryland, USA.

出版信息

J Vet Intern Med. 2021 Mar;35(2):1052-1061. doi: 10.1111/jvim.16078. Epub 2021 Feb 26.

Abstract

BACKGROUND

Locoregional tumor control and prolonged survival for dogs with genitourinary carcinoma (CGUC) reportedly are achievable using treatment with radiotherapy (RT) with or without adjunctive chemotherapy and nonsteroidal anti-inflammatory drugs (NSAIDs).

OBJECTIVES

To characterize event-free and overall survival after treatment of CGUC using NSAIDs, mitoxantrone (MTX), and a standardized RT protocol (57 Gy in 20 fractions).

ANIMALS

Fifty-one client-owned dogs treated between 2008 and 2017.

METHODS

Dogs were retrospectively categorized into treatment groups: (a) first-line concurrent chemoradiotherapy (≥1 dose of MTX started within 1 month of RT); (b) first-line chemotherapy (MTX administered for >1 month before RT without tumor progression); (c) RT as a salvage procedure (MTX, surgery or both with subsequent locoregional tumor progression before RT). Treatment-induced toxicoses, event-free survival (EFS), and overall survival times (OSTs) were recorded. The influence of demographics, staging, and treatment-related factors on survival was assessed using Cox proportional hazards modeling.

RESULTS

Median EFS and OST for all dogs were 260 and 510 days with no significant differences among groups 1 (n = 39), 2 (n = 4), and 3 (n = 8). Both EFS and OST were shorter in dogs with moderate to severe clinical signs (P < .001 and P < .001, respectively); OST was shorter in dogs with prostatic involvement (P = .02). Permanent urinary incontinence developed in 16 dogs (31%) at a median of 70 days postirradiation; other toxicoses were mild and self-limiting.

CONCLUSIONS AND CLINICAL IMPORTANCE

Mild clinical signs and lack of prostate involvement were associated with favorable prognosis for survival. Client education regarding the risk of urinary incontinence is warranted.

摘要

背景

据报道,使用放射治疗(RT)联合或不联合辅助化疗和非甾体抗炎药(NSAIDs)治疗泌尿生殖系统癌(CGUC),可以实现局部区域肿瘤控制和延长犬的生存时间。

目的

描述使用 NSAIDs、米托蒽醌(MTX)和标准化 RT 方案(57Gy 分 20 次)治疗 CGUC 后的无事件生存和总生存情况。

动物

2008 年至 2017 年间接受治疗的 51 只患犬。

方法

回顾性将犬分为治疗组:(a)一线同期放化疗(在 RT 开始后 1 个月内开始使用≥1 剂 MTX);(b)一线化疗(在 RT 前使用 MTX >1 个月而无肿瘤进展);(c)RT 作为挽救性治疗(在 RT 前使用 MTX、手术或两者联合治疗后局部区域肿瘤进展)。记录治疗相关毒性、无事件生存(EFS)和总生存时间(OST)。使用 Cox 比例风险模型评估人口统计学、分期和治疗相关因素对生存的影响。

结果

所有犬的中位 EFS 和 OST 分别为 260 天和 510 天,各组间无显著差异(组 1,n=39;组 2,n=4;组 3,n=8)。EFS 和 OST 在有中度至重度临床症状的犬中均较短(P<0.001 和 P<0.001);在前列腺受累的犬中 OST 较短(P=0.02)。16 只犬(31%)在放疗后中位 70 天出现永久性尿失禁;其他毒性反应轻微且自限性。

结论和临床意义

轻度临床症状和无前列腺受累与生存预后良好相关。有必要向宠物主人提供关于尿失禁风险的教育。

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