查看狗狗血管肉瘤的手术与多柔比星治疗的源代码

== 材料和方法 ==

1989 年 7 月 1 日至 1994 年 8 月 1 日期间，所有进入方案的带瘤犬都在科罗拉多州立大学的比较肿瘤学部门接受了治疗和评估。所有狗均根据美国国立卫生研究院《实验动物护理和使用指南》中概述的原则进行护理，实验设计得到了该机构动物护理和使用委员会的批准。46只狗的平均年龄和中位年龄和体重分别为9岁和9.3岁，体重分别为15岁和14.9公斤。每只狗的肿瘤都是根据世界卫生组织的分类方案进行分期的[7]。诊断方法取决于血管肉瘤的解剖部位和狗的健康状况。最低限度的初始和后续分期方案至少包括胸部和腹部放射线片、全血细胞计数、生化特征和尿液分析。在每种病例中，在确定原发肿瘤时，没有通过体格检查和射线图评估或在适当时进行超声检查检测到转移性疾病的临床证据。在手术时为每只狗获得了组织学诊断证明。46只患有血管肉瘤的狗（脾脏，n = 14；心脏，n = 5；有或没有肌肉受累的 SC 组织，n = 9；舌头、眼睛、肾脏、肋骨、肋骨、下颌骨、肺叶等皮肤以外的部位，n = 18）有原发肿瘤，并在可能的情况下，手术切除临床上明显的转移性疾病。在拆线时（手术后 I0 至 14 天），将阿霉素稀释在 150 mL 0.9% NaCl 中，每 3 周给药约 15 分钟 （30 mg/m2 IV），总共 5 次治疗或直到狗发展为进展性疾病。每位患者在 l 个月时进行评估，然后在最后一次给药后每 3 个月评估一次，或直到患者出现与肿瘤相关的任何疾病临床症状或死亡，以先发生者为准。重新评估包括但不限于体格检查和伦琴图的评估，或在适当的情况下，包括超声检查。在这项研究中，没有一只狗同时接受任何针对其肿瘤疾病的治疗。除 3 只狗外，所有狗都已确定转移性疾病 （-2 cm3） 并在最终手术时获得了活检标本;27 只狗 （59%） 在手术中切除了所有可测量的疾病。

All tumor-bearing dogs entered into the protocol were treatedand evaluated at the Comparative Oncology Unit at Colorado State University between July 1, 1989 and August 1, 1994. All dogs were cared for according to the principles outlined in the National Institutes of Health Guide for the Care and Use of Laboratory Animals, and the experimental design was approved by the institution alanimal care and use committee. The mean and median ages and weights of the 46 dogs were 9 and 9.3 years, and 15 and 14.9kg, respectively. Each dog's tumor was staged according to the classification scheme of the World Health Organization[7]. Diagnostic methods depended on the anatomic site of the hemangiosarcoma and the health status of the dog. Minimum initial and follow-upstaging schemes included at least thoracic and abdominal radio graphs, CBC, biochemical profile, and urinalysis. In each case, at the time the primary tumor was identified, there was no clinical evidence of metastatic disease detected by physical examination and evaluation of roentgenograms, or when appropriate, ultrasonograms.Histological proof of diagnosis was obtained at surgery for eachdog. Forty-six dogs with hemangiosarcoma (spleen, n = 14; heart,n = 5; SC tissue with or without muscle involvement, n = 9; sitesother than skin such as tongue, eye, kidney, rib, ornentum, mandible, lung lobe, n = 18) had the primary tumor, and when possible, clinically evident metastatic disease surgically removed. At the time of suture removal (I0 to 14 days after surgery), doxorubicin was diluted in 150 mL of 0.9% NaCl and administered over approximately 15 minutes (30 mg/m2 IV) every 3 weeks for a total of 5 treatments or until the dog developed progressive disease. Each patient was evaluated at l month and then every 3 months after the last drug administration, or until the time the patient showed any clinical signs of disease relating to the tumor or died, whichever occurred first. The re-evaluations included, but were not limited to physical examination and evaluation of roentgenograms, or when appropriate, ultrasonograms. None of the dogs in this study received any concurrent treatment for their neoplastic disease. All but 3 dogs had metastatic disease (-2 cm3) identified and biopsy specimens obtained at the time of the definitive surgery; 27 dogs (59%) had all measurable disease removed at surgery.


缓解持续时间定义为从肿瘤通过手术切除实现最大减小（完全缓解 [CR] 或部分缓解 [PR]）到恶性肿瘤大小进展到不符合 CR 或 PR 规格的时间。CR 被定义为所有临床可检测到的疾病消失;a PR 定义为所有可测量的肿瘤病灶的垂直直径乘积之和减少 250%，并且没有新肿瘤的证据：疾病稳定 （SD） 定义为每个可测量的肿瘤病灶的垂直直径乘积之和减少 <50% 或增加 <SO%，而没有发展新的肿瘤病灶;进行性疾病 （PD） 定义为每个可测量肿瘤的垂直直径乘积之和至少增加 50%，或出现新的肿瘤病变。为了防止过度解读阿霉素化疗的疗效，即使术后诊断程序此后未能识别出任何肿瘤，所有转移性病灶未完全切除的狗都被确定为患有 PR。这在一定程度上是因为未切除的病灶通常很小，降低了我们在术后测量这些病灶的信心。

The duration of remission was defined as the time from when the tumor achieved its maximal reduction in size by surgical resection (complete remission [CR] or partial remission [PR]), until the malignancy progressed in size so that it did not meet the specifications of a CR or PR. A CR was defined as the disappearance of all clinically detectable disease; a PR was defined as 250% decrease in the sum of the products of perpendicular diameters of all measurable neoplastic lesions and no evidence of new tumor: stable disease (SD) was defined as <50% decrease or <SO% increase in the sum of the products of perpendicular diameters of each measurable neoplastic lesion, without the development of new neoplastic lesions; and progressive disease (PD) was defined as an increase of at least 50% in the sum of the products of perpendicular diameter of each measurable tumor, or the appearance of new neoplastic lesions. To prevent overinterpreting the efficacy of doxorubicin chemotherapy, all dogs with metastatic lesions not completely removed were determined to have PR even if postoperative diagnostic procedures failed to identify any tumor thereafter. This was done in part because the unresected lesions were generally small, reducing our confidence for measuring these lesions postoperatively.

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