PDF(Pubmed)
Abstract：
UNASSIGNED: A variety of treatment options have been described for canine meningoencephalitis of unknown origin (MUO). Few studies focused on radiation therapy as a second line immunomodulating treatment, implicating its effective use. However, a standard radiation therapy protocol is lacking, and further research will help to evaluate the effect of different dose regimens.
UNASSIGNED: Ten dogs diagnosed with MUO based on MRI and CSF findings were prospectively enrolled. The dogs were treated with a shortened whole brain radiation therapy protocol (5 × 4 Gy) in combination with prednisolone. Neurologic changes were quantified using an established scoring scheme. Follow-up MRI and CSF examination was scheduled three months after radiation therapy. Overall survival and time to progression were calculated. Histopathology of the brain was performed in case of death.
UNASSIGNED: Seven dogs were diagnosed de novo and three had a history of relapsing MUO. Neurological status improved in all 10 dogs during radiation therapy, with 4/10 returning to normal shortly after radiation therapy. Three dogs died within the first three months after radiation therapy. At follow-up MRI lesions completely resolved in two dogs, partially resolved in five dogs, and progressed in one dog. After follow-up MRI, dogs were further treated with prednisolone monotherapy (two dogs) and additional immunosuppressant drugs (five dogs). Overall, four dogs showed disease progression, with a mean time to progression of 691 days (95%CI: 396-987) and mean overall survival for all dogs was 723 days (95%CI: 436-1011) (both medians not reached). Histopathology confirmed MUO in three dogs but was suggestive for oligodendroglioma in one dog. Radiation induced side effects were not seen.
UNASSIGNED: Shortened whole-brain radiation therapy could be an additional treatment option for MUO in conjunction to prednisolone, specifically for cases that require rapid relief of symptoms and with relapsing history.
UNASSIGNED: Ten dogs diagnosed with MUO based on MRI and CSF findings were prospectively enrolled. The dogs were treated with a shortened whole brain radiation therapy protocol (5 × 4 Gy) in combination with prednisolone. Neurologic changes were quantified using an established scoring scheme. Follow-up MRI and CSF examination was scheduled three months after radiation therapy. Overall survival and time to progression were calculated. Histopathology of the brain was performed in case of death.
UNASSIGNED: Seven dogs were diagnosed de novo and three had a history of relapsing MUO. Neurological status improved in all 10 dogs during radiation therapy, with 4/10 returning to normal shortly after radiation therapy. Three dogs died within the first three months after radiation therapy. At follow-up MRI lesions completely resolved in two dogs, partially resolved in five dogs, and progressed in one dog. After follow-up MRI, dogs were further treated with prednisolone monotherapy (two dogs) and additional immunosuppressant drugs (five dogs). Overall, four dogs showed disease progression, with a mean time to progression of 691 days (95%CI: 396-987) and mean overall survival for all dogs was 723 days (95%CI: 436-1011) (both medians not reached). Histopathology confirmed MUO in three dogs but was suggestive for oligodendroglioma in one dog. Radiation induced side effects were not seen.
UNASSIGNED: Shortened whole-brain radiation therapy could be an additional treatment option for MUO in conjunction to prednisolone, specifically for cases that require rapid relief of symptoms and with relapsing history.
摘要：
■对于未知来源的犬脑膜脑炎(MUO),已经描述了多种治疗选择。很少有研究集中在放射治疗作为二线免疫调节治疗，暗示其有效使用。然而,缺乏标准的放射治疗方案，进一步的研究将有助于评估不同剂量方案的效果。
■根据MRI和CSF结果诊断为MUO的10只狗被前瞻性纳入。用缩短的全脑放射治疗方案(5×4Gy)结合泼尼松龙治疗狗。使用已建立的评分方案量化神经系统变化。放疗后3个月安排随访MRI和CSF检查。计算总生存期和进展时间。在死亡的情况下进行脑的组织病理学。
■从头诊断出七只狗，三只有复发性MUO病史。在放射治疗期间，所有10只狗的神经状况都得到了改善，4/10在放射治疗后不久恢复正常。三只狗在放射治疗后的前三个月内死亡。在随访时，两只狗的MRI病变完全消退，部分解决了五只狗，在一只狗身上进步。MRI随访后,进一步用泼尼松龙单一疗法(2只狗)和其他免疫抑制药物(5只狗)治疗狗.总的来说,四只狗显示疾病进展，平均进展时间为691天(95CI:396-987),所有犬的平均总生存期为723天(95CI:436-1011)(均未达到中位数).组织病理学证实了三只狗的MUO，但提示一只狗的少突胶质细胞瘤。未观察到辐射诱导的副作用。
■缩短全脑放射治疗可能是MUO与泼尼松龙联合使用的额外治疗选择，特别适用于需要快速缓解症状和复发史的病例。
■根据MRI和CSF结果诊断为MUO的10只狗被前瞻性纳入。用缩短的全脑放射治疗方案(5×4Gy)结合泼尼松龙治疗狗。使用已建立的评分方案量化神经系统变化。放疗后3个月安排随访MRI和CSF检查。计算总生存期和进展时间。在死亡的情况下进行脑的组织病理学。
■从头诊断出七只狗，三只有复发性MUO病史。在放射治疗期间，所有10只狗的神经状况都得到了改善，4/10在放射治疗后不久恢复正常。三只狗在放射治疗后的前三个月内死亡。在随访时，两只狗的MRI病变完全消退，部分解决了五只狗，在一只狗身上进步。MRI随访后,进一步用泼尼松龙单一疗法(2只狗)和其他免疫抑制药物(5只狗)治疗狗.总的来说,四只狗显示疾病进展，平均进展时间为691天(95CI:396-987),所有犬的平均总生存期为723天(95CI:436-1011)(均未达到中位数).组织病理学证实了三只狗的MUO，但提示一只狗的少突胶质细胞瘤。未观察到辐射诱导的副作用。
■缩短全脑放射治疗可能是MUO与泼尼松龙联合使用的额外治疗选择，特别适用于需要快速缓解症状和复发史的病例。
