Théon A P, Madewell B R, Harb M F, Dungworth D L
Department of Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616.
J Am Vet Med Assoc. 1993 May 1;202(9):1469-75.
Seventy-seven dogs with malignant tumors of the nasal and paranasal cavities were treated by use of radiotherapy. The tumors included carcinomas (58) and sarcomas (19). Radiographic findings, including site of involvement and tumor extension, were the basis of clinical staging. Staging was performed according to the tumor, node, metastasis staging of the World Health Organization, and a modified staging scheme based on prognostic factors that seemed to correlate best with response to treatment. All irradiations were done with a telecobalt 60 unit. Fifty-six dogs were treated with irradiation alone, and 21 had partial tumor resection prior to radiotherapy. Treatment dose was 48 Gy (minimal tumor dose) administered on a Monday-Wednesday-Friday basis at 4 Gy/fraction over 4 weeks. The irradiation technique emphasized rostral field with a generous treatment volume. Duration of follow-up after irradiation ranged from 1 month to 61 months. The 1- and 2-year overall survival rates were 60.3% and 25%, respectively, and the 1- and 2-year relapse-free survival rates were 38.2% and 17.6%, respectively. Results of histologic examination and our modified staging scheme were significant (P = 0.02 and P = 0.04, respectively) prognostic factors of relapse-free survival. Conversely, tumor site, tumor extension, World Health Organization clinical stage, and cytoreductive surgery prior to irradiation did not affect the outcome of treatment. According to our modified staging scheme, dogs with stage-2- disease have a poorer prognosis than dogs with stage-1 disease, with a relative risk of relapse 2.3-fold higher. Dogs with carcinoma had a poorer prognosis than dogs with sarcoma (predominantly chondrosarcoma) with a relative risk of relapse 3.3-fold higher.(ABSTRACT TRUNCATED AT 250 WORDS)
77只患有鼻腔和鼻窦恶性肿瘤的犬接受了放射治疗。肿瘤包括癌(58例)和肉瘤(19例)。影像学检查结果,包括受累部位和肿瘤扩展情况,是临床分期的依据。分期根据世界卫生组织的肿瘤、淋巴结、转移分期标准以及基于与治疗反应似乎最相关的预后因素的改良分期方案进行。所有放疗均使用钴60远距离治疗机完成。56只犬仅接受放疗,21只在放疗前进行了部分肿瘤切除。治疗剂量为48 Gy(最小肿瘤剂量),每周一、三、五给药,每次4 Gy,共4周。放疗技术强调使用较大治疗体积的头侧野。放疗后的随访时间为1个月至61个月。1年和2年总生存率分别为60.3%和25%,1年和2年无复发生存率分别为38.2%和17.6%。组织学检查结果和我们的改良分期方案分别是无复发生存的显著预后因素(P值分别为0.02和0.04)。相反,肿瘤部位、肿瘤扩展情况、世界卫生组织临床分期以及放疗前的减瘤手术并不影响治疗结果。根据我们的改良分期方案,2期疾病的犬比1期疾病的犬预后更差,复发相对风险高2.3倍。癌犬比肉瘤(主要是软骨肉瘤)犬预后更差,复发相对风险高3.3倍。(摘要截断于250字)