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接受皮质类固醇和抗惊厥药物治疗的脑肿瘤犬的神经体征和磁共振成像特征的急性演变

Acute Evolution of Neurological Signs and Magnetic Resonance Imaging Features in Dogs With Brain Tumors Receiving Treatment With Corticosteroids and Anticonvulsants.

作者信息

Rossmeisl John H, Garcia-Mora Josefa K

机构信息

Department of Small Animal Clinical Sciences, Veterinary and Comparative Neuro-Oncology Laboratory, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA.

出版信息

J Vet Intern Med. 2025 May-Jun;39(3):e70126. doi: 10.1111/jvim.70126.

Abstract

BACKGROUND

Corticosteroids (CS) are a common treatment prescribed for dogs with brain tumors, but little data characterizing the clinical and neuroradiologic effects of CS treatment exist.

HYPOTHESES

Decreases in peritumoral brain edema (PBE) would be observed in dogs with brain tumors treated with CS and anticonvulsants, and decreases in edema would be accompanied by clinical improvement.

ANIMALS

Fifty dogs with gliomas and 22 with meningiomas.

MATERIALS AND METHODS

Retrospective case series. Dogs with brain tumors receiving treatments with CS and anticonvulsants underwent pre- and posttreatment clinical and brain magnetic resonance imaging (MRI) examinations within a 3-week follow-up period, and peritumoral edema and tumor volumes were calculated from each MRI study. Dogs were characterized as clinical responders or nonresponders independent of imaging results based on longitudinal changes in clinical findings and owner-reported quality of life (QOL). Clinicopathologic and MRI variables were compared pre- and posttreatment by clinical response.

RESULTS

At follow-up, 23/50 (46%) of dogs with glioma and 15/22 (68%) with meningioma were classified as clinical responders, and 23/50 (46%) of gliomas and 14/22 (64%) of meningiomas had decreases in edema volume. Responders had significantly larger decreases in edema and mass effect than nonresponders. Decreases in tumor volumes occurred in approximately 25% of gliomas.

CONCLUSIONS AND CLINICAL IMPORTANCE

Peritumoral brain edema was decreased in 50%-60% of gliomas and meningiomas in dogs at follow-up, and amelioration of edema often was accompanied by improved neurological signs and QOL. Corticosteroids may also clinically benefit dogs without PBE and can influence MRI surrogates used to determine glioma therapeutic responses.

摘要

背景

皮质类固醇(CS)是治疗犬脑肿瘤的常用药物,但关于CS治疗的临床和神经放射学效果的资料很少。

假设

在用CS和抗惊厥药治疗的脑肿瘤犬中,可观察到肿瘤周围脑水肿(PBE)减轻,且水肿减轻会伴随临床症状改善。

动物

50只患有胶质瘤的犬和22只患有脑膜瘤的犬。

材料与方法

回顾性病例系列研究。接受CS和抗惊厥药治疗的脑肿瘤犬在3周的随访期内进行了治疗前和治疗后的临床及脑磁共振成像(MRI)检查,并根据每次MRI研究计算肿瘤周围水肿和肿瘤体积。根据临床症状的纵向变化和主人报告的生活质量(QOL),将犬分为临床反应者或无反应者,与影像学结果无关。通过临床反应比较治疗前和治疗后的临床病理及MRI变量。

结果

随访时,50只胶质瘤犬中有23只(46%)和22只脑膜瘤犬中有15只(68%)被归类为临床反应者,50只胶质瘤中有23只(46%)和22只脑膜瘤中有14只(64%)的水肿体积减小。反应者的水肿和占位效应的减轻明显大于无反应者。约25%的胶质瘤出现肿瘤体积减小。

结论及临床意义

随访时,50%-60%的犬胶质瘤和脑膜瘤的肿瘤周围脑水肿减轻,水肿改善通常伴随着神经症状和生活质量的提高。皮质类固醇对无PBE的犬也可能有临床益处,并可影响用于确定胶质瘤治疗反应的MRI替代指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b936/12086991/fb19457d283a/JVIM-39-e70126-g001.jpg

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