Gillette S M, Gillette E L
Department of Radiological Health Sciences, Colorado State University, Ft Collins 80523, USA.
Semin Vet Med Surg Small Anim. 1995 Aug;10(3):168-72.
Radiation therapy may be indicated for larger invasive tumors of the head and neck that may be difficult to surgically excise or for which surgery would be significantly disfiguring. Previous studies of oral squamous cell carcinomas indicate that it should be possible to control approximately 80% of all but the most advanced local or locoregional tumors. Aggressive radiation therapy to total doses of 56 Gy or greater may be required. That can be done by using smaller doses per fraction and gradually reducing the size of the field so that the highest dose is given only to the tumor with a relatively tight margin. Malignant melanomas can be controlled locally apparently with a few large fractions. Metastatic disease limits survival; therefore, some type of systemic therapy seems to be needed to improve survival of those patients. Canine oral fibrosarcomas require a very high dose for a reasonable probability of control. It seems that a dose of 56 Gy given in 3.3 Gy fractions might provide local control of 50% of the tumors. It is likely that a combination of surgery and radiation would significantly improve the probability for control. Oral squamous cell carcinomas of cats must also be treated very aggressively to improve local control. Tumors of the nasal cavity are usually very large and invasive at the time of diagnosis. Radiation therapy has been shown to be effective in some instances. It is possible that with better definition of the tumor through computerized tomography imaging and improved treatment planning, control of these difficult to manage nasal tumors can be improved.
放射治疗可能适用于头颈部较大的侵袭性肿瘤，这些肿瘤可能难以通过手术切除，或者手术会造成明显的毁容。先前对口腔鳞状细胞癌的研究表明，除了最晚期的局部或区域肿瘤外，应该有可能控制大约80%的此类肿瘤。可能需要采用总剂量为56 Gy或更高的积极放射治疗。这可以通过每次分割使用较小剂量并逐渐缩小照射野大小来实现，以便仅对肿瘤及其相对紧密的边缘给予最高剂量。恶性黑色素瘤显然可以通过几次大分割照射在局部得到控制。转移性疾病会限制生存期；因此，似乎需要某种类型的全身治疗来提高这些患者的生存率。犬口腔纤维肉瘤需要非常高的剂量才能有合理的控制概率。似乎以3.3 Gy的分割剂量给予56 Gy的剂量可能会使50%的肿瘤得到局部控制。手术和放射治疗相结合很可能会显著提高控制概率。猫的口腔鳞状细胞癌也必须积极治疗以改善局部控制。鼻腔肿瘤在诊断时通常非常大且具有侵袭性。放射治疗在某些情况下已被证明是有效的。通过计算机断层扫描成像更好地界定肿瘤并改进治疗计划，有可能改善这些难以处理的鼻腔肿瘤的控制情况。
