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立体定向放疗(10 Gy X 3)治疗犬非淋巴瘤性鼻腔肿瘤与延长生存时间和严重放射性毒性的低风险相关。

Stereotactic radiotherapy (10 Gy X 3) for canine nonlymphomatous intranasal tumors is associated with prolonged survival and minimal risk of severe radiotoxicity.

机构信息

1Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.

2Comparative Medicine Institute, North Carolina State University, Raleigh, NC.

出版信息

J Am Vet Med Assoc. 2022 Jun 22;260(12):1496-1506. doi: 10.2460/javma.22.03.0141.

Abstract

OBJECTIVE

To describe oncologic outcomes following administration of a uniform stereotactic radiotherapy protocol (SRT; 10 Gy X 3) for canine intranasal tumors and to identify whether any clinical or dosimetric factors were predictive of event-free or overall survival time (EFST or OST).

ANIMALS

129 dogs.

PROCEDURES

In this single-institution retrospective study, the medical records database was searched for canine nonlymphomatous intranasal tumors treated with 10 Gy X 3 SRT between August 2013 and November 2020. Findings regarding adverse effects and outcomes were analyzed overall, for dogs grouped on the basis of life stage (mature adult, senior, or end of life), and for treatment-related or tumor-related variables to identify potential predictors of outcome.

RESULTS

After SRT, most dogs clinically improved with minimal acute radiotoxicity. The median EFST was 237 days; median OST was 542 days. Receipt of other tumor-directed therapies before or after SRT was associated with improved EFST in senior dogs (hazard ratio [HR], 0.416) and improved OST in mature adult (HR, 0.241) and senior dogs (HR, 0.348). In senior dogs, administration of higher near-minimum radiation doses was associated with improved EFST (HR, 0.686) and OST (HR, 0.743). In senior dogs, chondrosarcoma was associated with shorter OST (HR, 7.232), and in dogs at end of life, having a squamous cell or transitional carcinoma was associated with worse EFST (HR, 6.462).

CLINICAL RELEVANCE

This SRT protocol results in improved quality of life and prolonged OST for dogs of all life stages. Radiation protocol optimization or use of multimodal therapy may further improve outcomes.

摘要

目的

描述用于治疗犬鼻腔肿瘤的统一立体定向放射治疗(SRT;10 Gy X 3)方案的肿瘤学结果,并确定任何临床或剂量学因素是否可预测无事件生存时间(EFST)或总生存时间(OST)。

动物

129 只狗。

程序

在这项单机构回顾性研究中,检索了 2013 年 8 月至 2020 年 11 月期间接受 10 Gy X 3 SRT 治疗的非淋巴瘤性犬鼻腔肿瘤的病历数据库。对整体、基于生命阶段(成年、老年或生命末期)分组的狗、以及与治疗相关或肿瘤相关的变量进行了不良事件和结果分析,以确定潜在的预后因素。

结果

SRT 后,大多数狗的临床症状得到改善,且急性放射性毒性极小。中位 EFST 为 237 天;中位 OST 为 542 天。在 SRT 前或后接受其他肿瘤定向治疗与老年狗的 EFST 改善相关(风险比[HR],0.416),以及成年狗(HR,0.241)和老年狗(HR,0.348)的 OST 改善相关。在老年狗中,接受更高的近最小辐射剂量与 EFST(HR,0.686)和 OST(HR,0.743)的改善相关。在老年狗中,软骨肉瘤与较短的 OST 相关(HR,7.232),在生命末期的狗中,鳞状细胞癌或移行细胞癌与较差的 EFST 相关(HR,6.462)。

临床相关性

该 SRT 方案可提高所有生命阶段犬的生活质量并延长 OST。辐射方案的优化或使用多模态治疗可能会进一步改善结果。

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