Use of alternating administration of carboplatin and doxorubicin in dogs with microscopic metastases after amputation for appendicular osteosarcoma: 50 cases (1999-2006)
Use of alternating administration of carboplatin and doxorubicin in dogs with microscopic metastases after amputation for appendicular osteosarcoma: 50 cases (1999-2006)
复制标题
DOI：
10.2460/javma.232.10.1504
复制
发表时间：
2008-05-15
影响因子：
1.9
通讯作者：
Withrow, Stephen J.
中科院分区：
文献类型：
--
作者：
Bacon, Nicholas J.;Ehrhart, Nicole R.;Withrow, Stephen J.
目的-评价卡铂和多柔比星交替化疗方案对无骨肉瘤截肢后疑似显微镜下转移的犬的疗效和毒性，并评估患者、肿瘤、和与预后相关的治疗相关因素。设计-回顾性病例系列。动物- 50只客户拥有的狗。程序-回顾了因无骨肉瘤而截肢并接受卡铂和阿霉素交替化疗的犬的记录。化疗前，犬进行了完全分期，无可检测的转移。无病间隔（DFI），生存时间，和toxicoses的数据从医疗记录和业主或指兽医communications. Results-Median DFI为202天。中位生存时间为258天。29只（58%）犬按计划完成了方案，其余犬通常因转移或中毒而退出。9/50只（18%）犬报告了3级或4级骨髓抑制，6/50只（12%）犬报告了3级或4级胃肠道中毒。无化疗相关死亡。与DFI显著改善相关的单变量因素包括肿瘤位置（桡骨），接受阿霉素作为第一种药物，截肢后14天以上开始化疗，截肢骨扫描无肋骨病变。多变量因素与生存时间的显着改善肿瘤的位置（半径）和完成chemotherapy.Conclusions和临床相关性-交替给药卡铂和阿霉素导致DFI和生存时间类似的单剂协议的报告。客户应就中毒的可能性进行咨询。应进一步评估开始化疗的顺序和时间的相关性。
Objective - To evaluate the efficacy and toxicity of an alternating carboplatin and doxorubicin chemotherapy protocol in dogs with putative microscopic metastases after amputation for appendicular osteosarcoma and assess patient-, tumor-, and treatment-related factors for associations with prognosis.Design - Retrospective case series.Animals - 50 client-owned dogs.Procedures - Records of dogs that underwent amputation for appendicular osteosarcoma and received an alternating carboplatin and doxorubicin chemotherapy protocol were reviewed. Dogs had full staging and were free of detectable metastases prior to chemotherapy. Data on disease-free interval (DFI), survival time, and toxicoses were retrieved from medical records and owner or referring veterinarian communications.Results - Median DFI was 202 days. Median survival time was 258 days. Twenty-nine (58%) dogs completed the protocol as planned, and the rest were withdrawn typically because of metastases or toxicoses. Grade 3 or 4 myelosuppression was reported in 9 of 50 (18%) dogs and grade 3 or 4 gastrointestinal toxicosis in 6 of 50 (12%) dogs. There were no chemotherapy-related fatalities. Univariate factors associated with significant improvement in DFI included tumor location (radius), receiving doxorubicin as the first drug, starting chemotherapy more than 14 days after amputation, and no rib lesions on preamputation bone scans. Multivariate factors associated with a significant improvement in survival time were tumor location (radius) and completing chemotherapy.Conclusions and Clinical Relevance - Alternating administration of carboplatin and doxorubicin resulted in DFI and survival time similar to those reported for single-agent protocols. Clients should be counseled regarding the likelihood of toxicoses. Relevance of sequence and timing of starting chemotherapy should be further evaluated.