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犬颅内胶质瘤手术减瘤及替莫唑胺辅助化疗后的生存时间

Survival Time after Surgical Debulking and Temozolomide Adjuvant Chemotherapy in Canine Intracranial Gliomas.

作者信息

Hidalgo Crespo Emma, Farré Mariné Alba, Pumarola I Battle Martí, Borrego Massó Juan Francisco, Luján Feliu-Pascual Alejandro

机构信息

AÚNA Especialidades Veterinarias, Calle Algepser 22-1, 46980 Paterna, Valencia, Spain.

Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autonoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.

出版信息

Vet Sci. 2022 Aug 12;9(8):427. doi: 10.3390/vetsci9080427.

Abstract

Intracranial gliomas are associated with a poor prognosis, and the most appropriate treatment is yet to be defined. The objectives of this retrospective study are to report the time to progression and survival times of a group of dogs with histologically confirmed intracranial gliomas treated with surgical debulking and adjuvant temozolomide chemotherapy. All cases treated in a single referral veterinary hospital from 2014 to 2021 were reviewed. Inclusion criteria comprised a histopathological diagnosis of intracranial glioma, adjunctive chemotherapy, and follow-up until death. Cases were excluded if the owner declined chemotherapy or there was insufficient follow-up information in the clinical records. Fourteen client-owned dogs were included with a median time to progression (MTP) of 156 days (95% CI 133-320 days) and median survival time (MST) of 240 days (95% CI 149-465 days). Temozolomide was the first-line adjuvant chemotherapy but changed to another chemotherapy agent (lomustine, toceranib phosphate, or melphalan) when tumour relapse was either suspected by clinical signs or confirmed by advanced imaging. Of the fourteen dogs, three underwent two surgical resections and one, three surgeries. Survival times (ST) were 241, 428, and 468 days for three dogs treated twice surgically and 780 days for the dog treated surgically three times. Survival times for dogs operated once was 181 days. One case was euthanized after developing aspiration pneumonia, and all other cases after progression of clinical signs due to suspected or confirmed tumour relapse. In conclusion, the results of this study suggest that debulking surgery and adjuvant chemotherapy are well-tolerated options in dogs with intracranial gliomas in which surgery is a possibility and should be considered a potential treatment option. Repeated surgery may be considered for selected cases.

摘要

颅内胶质瘤的预后较差,目前尚未确定最合适的治疗方法。这项回顾性研究的目的是报告一组经组织学确诊的颅内胶质瘤犬在接受手术减瘤和辅助替莫唑胺化疗后的疾病进展时间和生存时间。对2014年至2021年在一家转诊兽医医院治疗的所有病例进行了回顾。纳入标准包括颅内胶质瘤的组织病理学诊断、辅助化疗以及随访至死亡。如果主人拒绝化疗或临床记录中随访信息不足,则排除这些病例。纳入了14只客户拥有的犬,其中位疾病进展时间(MTP)为156天(95%CI 133 - 320天),中位生存时间(MST)为240天(95%CI 149 - 465天)。替莫唑胺是一线辅助化疗药物,但当根据临床症状怀疑肿瘤复发或经高级影像学检查确诊时,改为另一种化疗药物(洛莫司汀、磷酸托西拉尼或美法仑)。在这14只犬中,3只接受了两次手术切除,1只接受了三次手术。接受两次手术治疗的3只犬的生存时间(ST)分别为241天、428天和468天,接受三次手术治疗的犬的生存时间为780天。接受一次手术的犬的生存时间为181天。1例因发生吸入性肺炎而实施安乐死,所有其他病例均在因怀疑或确诊肿瘤复发导致临床症状进展后实施安乐死。总之,本研究结果表明,对于有可能进行手术的颅内胶质瘤犬,减瘤手术和辅助化疗是耐受性良好的选择,应被视为一种潜在的治疗方案。对于某些选定的病例,可以考虑重复手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d32f/9414206/4d60f470e67b/vetsci-09-00427-g001.jpg

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