Urso Gaetano, Boncu Alexandra Gabriela, Carrara Nancy, Zaman Dragos-Teodor, Malfassi Luca, Marcarini Silvia, Minoli Lucia, Pavesi Simone, Sala Massimo, Scanziani Eugenio, Dolera Mario
Azienda Socio Sanitaria Territoriale di Lodi, 26900 Lodi, Italy.
La Cittadina Fondazione Studi e Ricerche Veterinarie, 26014 Romanengo, Italy.
Vet Sci. 2022 Sep 30;9(10):541. doi: 10.3390/vetsci9100541.
Gliomas are the second-most-common primary brain tumors in dogs. Surgery and radiotherapy are established treatment approaches with similar median survival time, whereas conventional chemotherapy is burdened by severe adverse effects. Spinal and leptomeningeal spread of gliomas have been described following radiotherapy treatment alone. The purpose of this study was to evaluate the outcome for four dogs with primary high-grade gliomas in the forebrain without evidence, at diagnosis, of neoplastic invasion along the spinal cord, that were treated with concomitant chemotherapy (temozolomide) and hypofractionated volumetric-modulated arc radiotherapy (VMAT-RT). Temozolomide was selected for its radiosensitive properties, and radiotherapy dose protocols of 37 Gy in 7 fractions or 42 Gy in 10 fractions were used. After an initial complete or partial response, tumors recurred across the cranial-spinal pathway. Post-mortem macroscopic examinations confirmed swollen spinal cord and hyperemic meningeal sleeve, with nodular lesions on the meningeal surface. Microscopically, infiltration of the spinal cord and meninges by neoplastic cells (with features of oligodendrogliomas) were observed. This work seems to suggest that the entire central nervous system should be investigated in diagnostic examinations of canine gliomas. Dose-escalation trials and/or spinal cord prophylaxis treatment could also be evaluated to prevent tumor progression.
神经胶质瘤是犬类第二常见的原发性脑肿瘤。手术和放射治疗是既定的治疗方法，中位生存时间相似，而传统化疗存在严重不良反应。单独放射治疗后曾有神经胶质瘤脊髓和软脑膜播散的报道。本研究的目的是评估4只前脑原发性高级别神经胶质瘤犬的治疗结果，这些犬在诊断时无脊髓肿瘤浸润证据，接受了同步化疗（替莫唑胺）和大分割容积调强弧形放疗（VMAT-RT）。选择替莫唑胺是因其具有放射敏感性，采用了7次分割给予37 Gy或10次分割给予42 Gy的放疗剂量方案。在最初出现完全或部分缓解后，肿瘤在颅脊髓通路复发。尸检宏观检查证实脊髓肿胀和脑膜袖充血，脑膜表面有结节状病变。显微镜下观察到肿瘤细胞（具有少突胶质细胞瘤特征）浸润脊髓和脑膜。这项工作似乎表明，在犬神经胶质瘤的诊断检查中应检查整个中枢神经系统。也可以评估剂量递增试验和/或脊髓预防性治疗以防止肿瘤进展。
