Drug-eluting bead chemoembolization for the treatment of nonresectable hepatic carcinoma in dogs: A prospective clinical trial.
Drug-eluting bead chemoembolization for the treatment of nonresectable hepatic carcinoma in dogs: A prospective clinical trial.
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DOI：
10.1111/jvim.16109
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发表时间：
2021-05
影响因子：
2.6
通讯作者：
Diniz MA
中科院分区：
文献类型：
--
作者：
Rogatko CP;Weisse C;Schwarz T;Berent AC;Diniz MA
犬不可切除肝癌（HC）的有效治疗选择有限。目的是通过计算机断层扫描（CT）评估报告药物洗脱微珠经动脉化疗栓塞（DEB-TACE）治疗犬不可切除HC后的结局、并发症和肿瘤缓解。作者假设严重并发症不常见，短期CT评估将显示疾病稳定或部分缓解。患有不可切除HC的客户所有犬（n = 16）。前瞻性单组临床试验对不同程度的血流淤滞进行了药物洗脱珠经动脉化疗栓塞。比较了初始治疗前和治疗后约12周的计算机断层扫描成像。在所有尝试中，药物洗脱珠经动脉化疗栓塞均成功给药。根据椭圆形肿瘤体积缓解（mL）的百分比变化，疾病稳定（8/13; 62%）是最常见的结局，其次是部分缓解（3/13; 23%）和疾病进展（2/13; 15%），初始治疗后中位时间为74天（范围，39 - 125）。DEB-TACE后的中位肿瘤体积（mL）减少了13%（范围：减少56%至增加77%）。7/27例（26%）治疗后发生与栓塞后综合征一致的轻度并发症。3/27例（11%）治疗后发生重大并发症：肝脓肿/败血症（2例）和胆囊炎/死亡（1例），导致2/27例（7%）治疗后治疗诱导死亡。治疗后的中位生存时间为337天（范围：22 - 1061天）。主诉体重减轻的犬（P = .02）的中位生存时间（126天;范围，46 - 337）显著短于既往无体重减轻史的犬（582天;范围，22 - 1061）。药物洗脱微珠经动脉化疗栓塞治疗不可切除的HC是一种可行的手术，在本研究样本中，85%的犬中促进了疾病稳定或部分缓解。
Effective treatment options for nonresectable hepatic carcinoma (HC) in dogs are limited. Objectives were to report outcomes, complications, and tumor responses via computed tomography (CT) assessment after drug‐eluting bead transarterial chemoembolization (DEB‐TACE) for nonresectable HC in dogs. The authors hypothesized that major complications would be uncommon and short‐term CT assessment would demonstrate stable disease or partial response. Client‐owned dogs (n = 16) with nonresectable HC. Prospective, single‐arm clinical trial. Drug‐eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis. Computed tomography imaging was compared before and approximately 12 weeks after initial treatment. Drug‐eluting bead transarterial chemoembolization was successfully administered in all attempts. Based on percent change in elliptical tumor volume response (mL), stable disease (8/13; 62%) was the most common outcome followed by partial response (3/13; 23%) and progressive disease (2/13; 15%) with a median of 74 days (range, 39‐125) after initial treatment. Median tumor volume (mL) after DEB‐TACE decreased in volume by 13% (range, 56% decrease to 77% increase). Mild complications consistent with postembolization syndrome occurred after 7/27 (26%) treatments. Major complications occurred after 3/27 (11%) treatments: hepatic abscess/septicemia (2) and cholecystitis/death (1), resulting in treatment‐induced death after 2/27 (7%) treatments. Median survival time after treatment was 337 days (range, 22‐1061). Dogs with a presenting complaint of weight loss (P = .02) had a significantly shorter median survival time (126 days; range, 46‐337) than those dogs without prior history of weight loss (582 days; range, 22‐1061). Drug‐eluting bead transarterial chemoembolization for nonresectable HC is a feasible procedure, which promoted stable disease or partial response in 85% of dogs in this study sample.
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