2024年6月24日 (一) 10:15的版本

Treatment of canine hemangiosarcoma: 2000 and beyond

https://doi.org/10.1892/0891-6640(2000)014%3C0479:tochab%3E2.3.co;2

1 摘要

犬血管肉瘤 （HSA） 是一种侵袭性恶性肿瘤，预后严重。手术和化疗在延长 HSA 狗狗的生存时间和提高生活质量方面的成功有限。肿瘤内科的进步正在提高兽医癌症患者的生存率和生活质量。对转移机制的理解导致了旨在延缓或抑制肿瘤扩散的新疗法的开发。有前途的新治疗选择包括新型给药系统（吸入或腔内化疗）;使用免疫调节剂，如脂质体封装的胞壁酰三肽-磷脂酰乙醇胺;抗转移药物，如血管生成抑制剂（干扰素、沙利度胺）、基质金属蛋白酶抑制剂和米诺环素;饮食调整;和基因治疗。血管生成抑制剂似乎是安全的，并且与传统化疗不同，不会引起耐药性。尽管许多较新的方法仍在开发和审查中，但使用结合创新治疗方式的多模式疗法可能为受 HSA 影响的狗提供最佳治疗选择。

Canine hemangiosarcoma (HSA) is an aggressive and malignant neoplasia with a grave prognosis. Surgery and chemotherapy have limited success in prolonging survival times and increasing quality of life in dogs with HSA. Advances in medical oncology are resulting in increased survival rates and a better quality of life for veterinary cancer patients. An understanding of mechanisms of metastasis has led to the development of new treatments designed to delay or inhibit tumor spread. Promising new treatment options include novel delivery systems (inhalation or intracavitary chemotherapy); use of immunomodulators such as liposome-encapsulated muramyl tripeptide-phosphatidylethanolamine; antimetastatic agents such as inhibitors of angiogenesis (interferons, thalidomide), matrix metalloproteinase inhibitors, and minocycline; dietary modifications; and gene therapy. Inhibitors of angiogenesis seem to be safe and, unlike conventional chemotherapy, do not induce drug resistance. Although many of the newer approaches are still under development and review, the use of multimodality therapy incorporating innovative treatment modalities may offer the best therapeutic option for dogs affected with HSA.

2 概述

3 传统疗法 (Traditional Therapy)

从历史上看，手术一直是 HSA 的首选治疗方法，尽管它对改善总体生存时间几乎没有作用.4,18,19 三项对仅通过手术治疗的脾脏 HSA 狗的研究报告称，中位生存时间为 2-3 个月[4,18,19]。心脏 HSA 的手术切除也产生了不令人满意的结果，中位生存时间从 3 到 5 个月不等[20-22]。皮肤 HSA 通常与更长的生存时间有关[23]。由于手术的局限性[11]，据报道，基于多柔比星的各种方案，无论是否添加长春新碱和环磷酰胺，都具有最佳生存时间[2,3,24-27]。已发表的方案包括单药阿霉素（30 mg/m^2，静脉注射，每 3 周一次，最多 5 个周期）；多柔比星和环磷酰胺（阿霉素作为单药方案，在每 3 周周期的第 3-6 天静脉注射环磷酰胺 50-75 mg/m^2）；和长春新碱、多柔比星和环磷酰胺（多柔比星作为单药方案，环磷酰胺在每 3 周周期的第 1 天静脉注射 100 mg/m^2，长春新碱在每个周期的第 8 天和第 15 天静脉注射）[1-3,24-26]。据报道，各种基于多柔比星的方案的生存时间从 140 到 202 天不等， 虽然没有任何一个方案明显更好。

Historically, surgery has been the treatment of choice for HSA, although it does little to improve overall survival times.4,18,19 Three studies of dogs with splenic HSA treated by surgery alone reported median survival times of 2–3 months.4,18,19 Surgical excision for cardiac HSA also yields unsatisfactory results, with median survival times ranging from 3 to 5 months.20–22 Cutaneous HSA is generally associated with longer survival times.23 Because of the limitations of surgery, chemotherapy has evolved into a principal component of therapy.11 Various protocols based on doxorubicin with and without the addition of vincristine and cyclophosphamide have been reported to have the best survival times.2,3,24–27 Published protocols include single-agent doxorubicin (30 mg/m2 intravenously every 3 weeks for up to 5 cycles); doxorubicin and cyclophosphamide (doxorubicin as for single-agent protocol, with cyclophosphamide incorporated at 50–75 mg/m2 intravenously on days 3–6 of every 3-week cycle); and vincristine, doxorubicin, and cyclophosphamide (doxorubicin as for single-agent protocol, with cyclophosphamide incorporated at 100 mg/m2 intravenously on day 1 of every 3-week cycle, and vincristine at 0.75 mg/m2 intravenously on days 8 and 15 of each cycle).1–3,24–26 Survival times ranging from 140 to 202 days have been reported for the various doxorubicin-based protocols, although no protocol is clearly superior [3,24-27].

4 Reference

• Doxorubicin chemotherapy for presumptive cardiac hemangiosarcoma in dogs 2014 阿霉素化疗治疗狗的推定性心脏血管肉瘤

• Comparison of doxorubicin-cyclophosphamide with doxorubicin-dacarbazine for HSA 2017 多柔比星-环磷酰胺与多柔比星-达卡巴肼辅助治疗犬血管肉瘤的比较