查看狗狗血管肉瘤的手术与多柔比星治疗的源代码

== 概述 ==

手术是血管肉瘤的初始治疗选择[1-4] 然而，由于这种肿瘤的快速生长和转移，手术对延长除皮肤血管肉瘤外的所有疾病的狗的生存期几乎没有作用。单独手术治疗脾脏和右心房血管肉瘤的结果
中位生存时间 （STs） 范围为 19 至 83 天。[1-4] 只有疾病分期被证明是一个重要的预后变量。由于对手术的反应不佳，化疗已被评估为延长无病间隔 （DFI） 和受影响患者生存期的一种手段。[6,7] 使用长春新碱、多柔比星和环磷酰胺联合治疗的脾脏血管肉瘤犬的中位 ST 为 164 天。[6] 在另一组接受多柔比星和环磷酰胺的狗中，中位 ST 为 179 天 [7] 尽管这些报告表明联合化疗可能有效，但这些方案导致了一些毒性。两项研究的毒性包括中性粒细胞减少症和胃肠道体征，严重到足以导致15只狗中有7只（46.7%）和16只狗中有3只（18.8%）需要住院治疗。[6,7] 每项研究中都有一只狗死于败血症，这是化疗引起的中性粒细胞减少症的结果。

联合化疗的基本原则之一是每种药物在单独使用时都应该有效。关于阿霉素作为单一药物治疗血管肉瘤的疗效的数据很少。因此，本研究的目的是前瞻性地确定患有血管肉瘤的狗的 DFI 和 ST，其中肿瘤被部分或全部切除，然后用阿霉素治疗。此外，还分析了各种因素（协变量），以确定它们是否有助于预测 DFI 和 ST。


surgery is the initial treatment of choice for hemangiosarcoma [1-4] However, because of the rapid growth and metastases of this tumor, surgery does little to prolong survival of dogs with all but cutaneous hemangiosarcomas. Surgery alone for splenic and right atrial hemangiosarcomas results
in median survival times (STs) ranging from 19 to 83 days. [1-4] Only stage of disease has been shown to be an important prognostic variable.' Because of the poor response to surgery, chemotherapy has been evaluated as a means to prolong disease-free interval (DFI) and survival of affected patients. [6,7] The median STs of dogs with splenic hemangiosarcoma treated with a combination of vincristine, doxorubicin, and cyclophosphamide, followed by chlorarnbucil and methotrexate, was 164 days. [6] In another group of dogs that received doxorubicin and cyclophosphamide, the median ST was 179 days [7] Although these reports suggest that combination chemotherapy may be effective, these protocols resulted in some toxicity. Toxicities in both studies included neutropenia and gastrointestinal signs severe enough to necessitate hospitalization in 7 of 15 (46.7%) and 3 of 16 (18.8%) dogs, respectively. [6,7] One dog in each study died of sepsis as a result of chemotherapy-induced neutropenia. 

One of the basic tenents of combination chemotherapy is that each drug should be effective when used alone. Few data exist concerning the efficacy of doxorubicin as a single agent for the treatment of hemangiosarcoma. Therefore, the objectives of this study were to prospectively determine the DFI and ST of dogs with hemangiosarcoma in which the tumor was partially or totally excised, and were then treated with doxorubicin. In addition, various factors (covariates) were analyzed to determine if they can help predict DFI and ST. 

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