Griffin Maureen A, Mastorakis Andrea, Wustefeld-Janssens Brandan, Martin Tiffany Wormhoudt, Duda Lili, Seguin Bernard, Tremolada Giovanni
Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States.
Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States.
Front Vet Sci. 2024 Jan 11;10:1283728. doi: 10.3389/fvets.2023.1283728. eCollection 2023.
Information on dogs that undergo radiation therapy (RT) with non-stereotactic protocols in addition to surgical stabilization with implant placement for treatment of bone tumors is limited.
Our primary objectives were to describe the clinical characteristics as well as short- and long-term outcomes, including complications, function, and disease progression, in dogs that underwent both surgical stabilization with implant placement and non-stereotactic RT for local treatment of a bone tumor.
A bi-institutional retrospective case series was performed.
Eight client-owned dogs that underwent both surgical stabilization with implant placement and non-stereotactic RT for local treatment of a bone tumor were included.
Tumor types included osteosarcoma or suspected osteosarcoma (5), plasma cell tumor (2), and grade 3 fibrosarcoma (1). Radiation protocols were hypofractionated (palliative intent) in 5 dogs and fractionated (definitive intent) in 3 dogs. Five dogs experienced complications following both RT and surgery, including grade 1 complications in two dogs, a grade 2 complication in one dog, both grade 1 and 2 complications in one dog, and both grade 2 and 3 complications in one dog. Clinical signs subjectively improved in all dogs that had outcomes relative to function documented post-surgery/RT (7). Of these 7 dogs, 4 maintained long-term improvement in function and clinical signs, whereas 3 experienced subsequent recurrence/progression of clinical signs at a median of 133 days (range 91-186) postoperatively in association with biomechanical complications (screw loosening), surgical site infection, and local disease progression in 1 dog each; subsequent treatment resulted in improved clinical signs for each of these 3 dogs, such that overall good long-term functional outcomes were experienced. No dogs required amputation or additional vertebral surgery as salvage for local disease control or palliation. The median progression free interval was 206 days (range 25-1078), and the median survival time was 253 days (range 122-1078) with 1 additional dog lost to follow-up at 575 days. Two dogs experienced local disease progression, and 6 dogs experienced systemic disease progression; both dogs that developed local disease progression received palliative intent RT protocols.
In this cohort, dogs with primary bone tumors that underwent surgical stabilization with implant placement and hypofractionated or fractionated non-stereotactic RT for local treatment had a low incidence of major complications, good limb function and ambulation post-treatment, and relatively prolonged survival times despite disease progression.
对于接受非立体定向放疗方案联合植入物手术固定治疗骨肿瘤的犬只，相关信息有限。
我们的主要目的是描述接受植入物手术固定和非立体定向放疗以局部治疗骨肿瘤的犬只的临床特征以及短期和长期结局，包括并发症、功能和疾病进展情况。
进行了一项双机构回顾性病例系列研究。
纳入8只接受植入物手术固定和非立体定向放疗以局部治疗骨肿瘤的客户拥有的犬只。
肿瘤类型包括骨肉瘤或疑似骨肉瘤（5只）、浆细胞瘤（2只）和3级纤维肉瘤（1只）。放疗方案中，5只犬采用大分割放疗（姑息性目的），3只犬采用常规分割放疗（根治性目的）。5只犬在放疗和手术后出现并发症，包括2只犬出现1级并发症，1只犬出现2级并发症，1只犬同时出现1级和2级并发症，1只犬同时出现2级和3级并发症。所有记录了术后/放疗后功能结局的犬只主观临床症状均有改善（7只）。在这7只犬中，4只犬功能和临床症状长期改善，而3只犬术后中位133天（范围91 - 186天）出现临床症状复发/进展，分别与生物力学并发症（螺钉松动）、手术部位感染和局部疾病进展有关；后续治疗使这3只犬的临床症状均得到改善，总体获得良好的长期功能结局。没有犬只因局部疾病控制或姑息治疗需要截肢或额外的椎体手术。无进展生存期的中位数为206天（范围25 - 1,078天），中位生存时间为253天（范围12,2 - 1,078天），另有1只犬在575天时失访。2只犬出现局部疾病进展，6只犬出现全身疾病进展；2只出现局部疾病进展的犬只均接受了姑息性放疗方案。
在该队列中，患有原发性骨肿瘤的犬只接受植入物手术固定以及大分割或常规分割非立体定向放疗进行局部治疗，尽管疾病进展，但主要并发症发生率低，治疗后肢体功能和行走能力良好，生存时间相对延长。
