285只犬疑似颅内脑膜瘤放疗或手术治疗后的生存情况比较

Comparison of Survival After Treatment of Presumed Intracranial Meningioma by Radiotherapy or Surgery in 285 Dogs.

作者信息

Geiger Rachel, Mankin Joe, Volk Holger A, de Decker Steven, van Asselt Nate, Randhawa Karanbir, Ehling Tara, Maitz Charles A, Naramor Ada, Coates Joan R, Stalin Catherine, Johnstone Lauren, Morris Joanna, Plessas Ioannis N, Forward Alexander, Garosi Laurent, Scarpante Elena, Cherubini Giunio, Harcourt-Brown Tom, Carrera-Justiz Sheila, Gutti Jishnu Rao, Takada Marilia, White Joel, Nagata Koichi, Kent Marc, Barber Renee, Ito Daisuke, Nakayama Tomohiro, Oshima Ayaka, Sekigucki Naoki, Smith-Oskrochi Lauren, Jeffery Nick

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.

出版信息

J Vet Intern Med. 2025 Mar-Apr;39(2):e70011. doi: 10.1111/jvim.70011.

DOI:10.1111/jvim.70011

PMID:39968764

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11836666/

Abstract

BACKGROUND

The comparative effectiveness of radiotherapy and surgery for treating intracranial meningioma is unknown.

OBJECTIVES

To compare survival after treatment of suspected intracranial meningioma by either surgery or radiotherapy.

ANIMALS

Two hundred eighty-five companion dogs with suspected intracranial meningiomas presenting to 11 specialty clinics in three countries.

METHODS

Parallel cohort comparison study on retrospective data. Dogs diagnosed with intracranial meningioma by board-certified veterinary neurologists or radiologists and treated by radiotherapy or surgery were identified through medical record searches and presenting and survival data extracted. Lesion site was classified as rostro- or caudotentorial and size was measured on contrast magnetic resonance images. Outcome was all-cause death. Analysis of survival by Cox proportional hazards, including selection for optimal multivariable model using lasso, counterfactual modeling including variables associated with treatment allocation and survival.

RESULTS

One hundred sixty-eight dogs received radiotherapy and 117 received surgery. All analyses indicated reduced survival associated with surgery compared to radiotherapy. There was a median survival after surgery of 297 (IQR: 99-768) days compared with 696 (IQR: 368-999) for dogs treated by radiation, associated with a univariable hazard ratio of 1.802 (95% CI: 1.357-2.394). Counterfactual modeling estimated a mean survival of 480 (95% CI: 395-564) days after surgery and 673 (95% CI: 565-782) days after radiotherapy, representing a decrease in survival of 29%. Location and size of the lesion were not associated with survival duration.

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs with suspected intracranial meningioma have substantially superior survival after radiotherapy compared to surgery.

摘要

背景

放射治疗和手术治疗颅内脑膜瘤的相对有效性尚不清楚。

目的

比较手术或放射治疗疑似颅内脑膜瘤后的生存率。

动物

来自三个国家11家专科诊所的285只疑似颅内脑膜瘤的伴侣犬。

方法

对回顾性数据进行平行队列比较研究。通过病历检索确定经认证的兽医神经科医生或放射科医生诊断为颅内脑膜瘤并接受放射治疗或手术的犬，并提取就诊和生存数据。病变部位分为幕上或幕下，并在对比磁共振图像上测量大小。结局为全因死亡。采用Cox比例风险模型分析生存率，包括使用套索法选择最佳多变量模型，采用反事实建模，纳入与治疗分配和生存相关的变量。

结果

168只犬接受了放射治疗，117只犬接受了手术。所有分析均表明，与放射治疗相比，手术治疗后的生存率降低。手术后的中位生存期为297（四分位间距：99 - 768）天，而接受放射治疗的犬为696（四分位间距：368 - 999）天，单变量风险比为1.802（95%置信区间：1.357 - 2.394）。反事实建模估计手术后的平均生存期为480（95%置信区间：395 - 564）天，放射治疗后为673（95%置信区间：565 - 782）天，生存率降低了29%。病变的位置和大小与生存时间无关。