- 學位論文
評估15 週 LHOP化療療程對多中心型淋巴瘤犬隻的療效
Evaluate the efficacy of a 15-week LHOP chemotherapy protocol including vincristine, L-asparaginase, doxorubicin, and prednisolone on dogs with multicentric lymphoma
摘要
多中心型淋巴癌是犬隻最常見的惡性腫瘤，若不進行任何治療，存活時間可能不到六週。目前在小動物的淋巴癌治療上，主要是以CHOP (C，環磷酰胺；H，阿黴素；O，長春新鹼和P，類固醇)化療療程為基底的誘導治療。這個治療療程當中包含了四個週期的療程。獸醫師藉由縮短治療週期和搭配不一樣的藥物，希望能減少治療的花費和增加犬隻的生活品質。CHOP化療療程為基底的化療從25週逐漸縮減成15週都有相似的治療效果。 在這項研究中，我們將19週的LHOP (L，天冬酰胺酶；H，阿黴素；O，長春新鹼和P，類固醇)化療療程縮短成15週希望能讓動物的生活品質更好和減少飼主的花費。然而在縮短治療時間減少了四次vincristine投予之後，結果顯示，縮短後的治療有統計上顯著較差的疾病無進展生存時間（p=0.006）和生存時間（p=0.018）。在15週LHOP化療療程和19週LHOP化療療程的中位疾病無進展生存時間分別為265天和401天，而中位存活時間分別為420天和530天。而兩組在年紀（p=0.851）、體重（p=0.934）、性別（p=0.093）、臨床分期（p=0.448）、亞分期（p=0.396）、免疫表型（p=0.344）、和總血清鈣（p=0.474）在統計上都沒有顯著差異。因此不建議將19週LHOP化療療程縮短為15週LHOP。
並列摘要
Lymphoma is the most common malignant tumor in dogs. Without therapy, dogs with lymphoma may survive less than 6 weeks. In current clinical practice, the majority of veterinarians utilize a CHOP-based (C, cyclophosphamide; H, doxorubicin; O, vincristine; and P, prednisolone) chemotherapy protocol as an induction protocol to treat lymphoma. This protocol includes four cycles. To reduce costs and improve the quality of life for dogs, veterinarians have attempted to shorten the chemotherapy protocol and combine different drugs. The CHOP protocol shortened from 25 weeks to 15 weeks showed similar efficacy. In our study, we shortened the 19-week LHOP (L, L-asparaginase; H, doxorubicin; O, vincristine; and P, prednisolone) to a 15-week LHOP to improve the patient's quality of life and reduce the cost of treatment. However, after omitting four doses of vincristine, the results showed that the 15-week LHOP had worse progression-free survival and overall survival time than the 19-week LHOP, with significant differences, indicated by p-values of 0.006 and 0.018, respectively. The median progression-free survival of the 15-week LHOP and 19-week LHOP were 265 and 401 days, respectively. The median overall survival time of the 15-week LHOP and 19-week LHOP were 420 and 530 days, respectively. No significant differences were found in age (p=0.851), body weight (p=0.934), gender ratio (p=0.093), clinical stage (p=0.448), substage (p=0.396), immunophenotype (p=0.344), and total serum calcium (p=0.474). Therefore, shortening the 19-week LHOP to a 15-week LHOP is not recommended.