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载药微球化疗栓塞术治疗不可切除性犬肝癌的前瞻性临床试验。

Drug-eluting bead chemoembolization for the treatment of nonresectable hepatic carcinoma in dogs: A prospective clinical trial.

机构信息

The Animal Medical Center, New York, New York, USA.

Veterinary Surgical Centers, Vienna, Virginia, USA.

出版信息

J Vet Intern Med. 2021 May;35(3):1487-1495. doi: 10.1111/jvim.16109. Epub 2021 May 6.

Abstract

BACKGROUND

Effective treatment options for nonresectable hepatic carcinoma (HC) in dogs are limited.

HYPOTHESIS/OBJECTIVE: Objectives were to report outcomes, complications, and tumor responses via computed tomography (CT) assessment after drug-eluting bead transarterial chemoembolization (DEB-TACE) for nonresectable HC in dogs. The authors hypothesized that major complications would be uncommon and short-term CT assessment would demonstrate stable disease or partial response.

ANIMALS

Client-owned dogs (n = 16) with nonresectable HC.

METHODS

Prospective, single-arm clinical trial. Drug-eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis. Computed tomography imaging was compared before and approximately 12 weeks after initial treatment.

RESULTS

Drug-eluting bead transarterial chemoembolization was successfully administered in all attempts. Based on percent change in elliptical tumor volume response (mL), stable disease (8/13; 62%) was the most common outcome followed by partial response (3/13; 23%) and progressive disease (2/13; 15%) with a median of 74 days (range, 39-125) after initial treatment. Median tumor volume (mL) after DEB-TACE decreased in volume by 13% (range, 56% decrease to 77% increase). Mild complications consistent with postembolization syndrome occurred after 7/27 (26%) treatments. Major complications occurred after 3/27 (11%) treatments: hepatic abscess/septicemia (2) and cholecystitis/death (1), resulting in treatment-induced death after 2/27 (7%) treatments. Median survival time after treatment was 337 days (range, 22-1061). Dogs with a presenting complaint of weight loss (P = .02) had a significantly shorter median survival time (126 days; range, 46-337) than those dogs without prior history of weight loss (582 days; range, 22-1061).

CONCLUSIONS

Drug-eluting bead transarterial chemoembolization for nonresectable HC is a feasible procedure, which promoted stable disease or partial response in 85% of dogs in this study sample.

摘要

背景

目前,犬非手术治疗性肝癌(HC)的有效治疗方法十分有限。

假设/目的:本研究旨在报告采用载药微球动脉化疗栓塞术(DEB-TACE)治疗犬非手术治疗性 HC 的结果、并发症和通过 CT 评估肿瘤反应,并假设主要并发症不常见,且短期 CT 评估将显示疾病稳定或部分缓解。

动物

16 只患有非手术治疗性 HC 的患犬。

方法

前瞻性、单臂临床试验。根据血流淤滞程度,对患犬进行不同程度的 DEB-TACE。比较初始治疗前后的 CT 图像。

结果

所有尝试均成功进行了 DEB-TACE。根据椭圆形肿瘤体积反应(mL)的百分比变化,疾病稳定(8/13;62%)是最常见的结果,其次是部分缓解(3/13;23%)和疾病进展(2/13;15%),初始治疗后中位数为 74 天(范围 39-125 天)。DEB-TACE 后,肿瘤体积中位数(mL)体积减少了 13%(范围 56%减少至 77%增加)。27 次治疗中有 7 次(26%)出现与栓塞后综合征一致的轻度并发症。3 次(11%)治疗出现主要并发症:肝脓肿/败血症(2 次)和胆囊炎/死亡(1 次),导致 2 次(7%)治疗出现治疗相关死亡。治疗后中位生存时间为 337 天(范围 22-1061 天)。与无体重减轻病史的患犬相比,以体重减轻为首发症状的患犬(P=0.02)的中位生存时间明显更短(126 天;范围 46-337 天)。

结论

DEB-TACE 治疗犬非手术治疗性 HC 是一种可行的方法,本研究样本中 85%的犬表现出疾病稳定或部分缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4981/8162590/4682518c3313/JVIM-35-1487-g002.jpg

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