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Nytko KJ, Weyland MS, Dressel-Böhm S, Scheidegger S, Salvermoser L, Werner C, Stangl S, Carpinteiro AC, Alkotub B, Multhoff G, Bodis S, Rohrer Bley C. Extracellular heat shock protein 70 levels in tumour-bearing dogs and cats treated with radiation therapy and hyperthermia. Vet Comp Oncol 2023; 21:605-615. [PMID: 37653682 DOI: 10.1111/vco.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 09/02/2023]
Abstract
Hyperthermia is a form of a cancer treatment which is frequently applied in combination with radiotherapy (RT) to improve therapy responses and radiosensitivity. The mode of action of hyperthermia is multifactorial; the one hand by altering the amount of the blood circulation in the treated tissue, on the other hand by modulating molecular pathways involved in cell survival processes and immunogenic interactions. One of the most dominant proteins induced by hyperthermia is the major stress-inducible heat shock protein 70 (Hsp70). Hsp70 can be found in the blood either as a free-protein (free HSP70) derived from necrotic cells, or lipid-bound (liposomal Hsp70) when it is actively released in extracellular vesicles (EVs) by living cells. The aim of the study was to evaluate the levels of free and liposomal Hsp70 before and after treatment with RT alone or hyperthermia combined with radiotherapy (HTRT) in dogs and cats to evaluate therapy responses. Peripheral blood was collected from feline and canine patients before and at 2, 4, 6 and 24 h after treatment with RT or HTRT. Hsp70 enzyme-linked immunosorbent assays (ELISAs) were performed to determine the free and liposomal Hsp70 concentrations in the serum. The levels were analysed after the first fraction of radiation to study immediate effects and after all applied fractions to study cumulative effects. The levels of free and liposomal Hsp70 levels in the circulation were not affected by the first singular treatment and cumulative effects of RT in cats however, after finalizing all treatment cycles with HTRT free and liposomal Hsp70 levels significantly increased. In dogs, HTRT, but not treatment with RT alone, significantly affected liposomal Hsp70 levels during the first fraction. Free Hsp70 levels were significantly increased after RT, but not HTRT, during the first fraction in dogs. In dogs, on the other hand, RT alone resulted in a significant increase in liposomal Hsp70, but HTRT did not significantly affect the liposomal Hsp70 when cumulative effects were analysed. Free Hsp70 was significantly induced in dogs after both, RT and HTRT when cumulative effects were analysed. RT and HTRT treatments differentially affect the levels of free and liposomal Hsp70 in dogs and cats. Both forms of Hsp70 could potentially be further investigated as potential liquid biopsy markers to study responses to RT and HTRT treatment in companion animals.
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Affiliation(s)
- K J Nytko
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - M S Weyland
- ZHAW School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - S Dressel-Böhm
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - S Scheidegger
- ZHAW School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - L Salvermoser
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TranslaTUM-Central Institute for Translational Cancer Research, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - C Werner
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TranslaTUM-Central Institute for Translational Cancer Research, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - S Stangl
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TranslaTUM-Central Institute for Translational Cancer Research, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - A C Carpinteiro
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TranslaTUM-Central Institute for Translational Cancer Research, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - B Alkotub
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TranslaTUM-Central Institute for Translational Cancer Research, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - G Multhoff
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TranslaTUM-Central Institute for Translational Cancer Research, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - S Bodis
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - C Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
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Sylvester SR, Henry JG, Basran PS, McEntee MC. Description and efficacy of a response-based "QUAD" cyclical hypofractionated palliative-intent radiation protocol in dogs with macroscopic solid tumours: 108 cases. Vet Comp Oncol 2023; 21:378-390. [PMID: 37068761 DOI: 10.1111/vco.12896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/17/2023] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
Palliative-intent radiation therapy can alleviate pain and clinical signs in dogs with cancer, but optimal fractionation scheme is unknown. The objective of this retrospective case series is to evaluate clinical benefit, objective response, adverse effects, and outcomes in 108 dogs with macroscopic solid tumours treated with a cyclical "QUAD" hypofractionated palliative-intent radiation therapy protocol. Median QUAD dose was 14 Gy (14-16 Gy). Median total dose was 28 Gy (14-48 Gy). Clinical benefit rate was 93%, with median onset of subjective palliation 21 days after the first QUAD, lasting a median of 134 days. Tumour volumetric objective response was assessed with CT prior to the third QUAD in 36 dogs, with stable disease in 24 dogs (67%) and partial response in 9 dogs (25%). Sinonasal and oral were the most common tumour locations in 32 and 30 dogs, respectively. Median progression-free survival was 153 days (95% CI 114-200). Median overall survival was 212 days (95% CI 152-259). Number of QUAD cycles completed, clinical benefit achieved, anti-inflammatory received, total radiation dose, time to maximum clinical benefit, and response duration were positively associated with progression-free and overall survival. Acute toxicities were observed in 15 dogs (14%) with 3 high-grade (grade 3) toxicities (3%). Low-grade (grade 1 and 2) late skin and ocular toxicities were observed in 31 dogs (29%), predominantly leukotrichia, alopecia, keratoconjunctivitis sicca, and cataracts. This report demonstrates that QUAD radiation is an alternative protocol to be considered for palliation of dogs with inoperable or advanced stage solid tumours.
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Affiliation(s)
- Skylar R Sylvester
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Joshua G Henry
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Parminder S Basran
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Margaret C McEntee
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
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3
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Altwal J, Martin TW, Thamm DH, Séguin B. Configuration of pathologic fractures in dogs with osteosarcoma following stereotactic body radiation therapy: A retrospective analysis. Vet Comp Oncol 2023; 21:131-137. [PMID: 36633386 DOI: 10.1111/vco.12877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 01/13/2023]
Abstract
For some cases of canine appendicular osteosarcoma (OSA), limb-sparing treatment options are often desired, one of which is stereotactic body radiation therapy (SBRT). A major complication of SBRT is fracture of the irradiated bone at the site of treatment. The present study evaluated 127 appendicular OSA sites in 122 dogs treated with SBRT to identify the most common pathologic fracture locations and configurations. A total of 50 tumours experienced a pathologic fracture, and 38 had imaging sufficient to identify fracture configuration. The distal tibia was more likely to develop a fracture than other sites. Multiple types of fracture configuration (transverse, oblique, spiral and comminuted) were observed. The distal radius was significantly more likely to develop a transverse fracture than other sites. Documentation of fracture location and configuration leads to the identification of the forces contributing to fracture occurrence, since each configuration is a result of different forces acting on each affected bone. Such knowledge is imperative for the development of new approaches to diminish the occurrence of pathologic fractures.
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Affiliation(s)
- Johnny Altwal
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Tiffany Wormhoudt Martin
- Flint Animal Cancer Center and Department of Environmental and Radiological Health Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center and Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Bernard Séguin
- Flint Animal Cancer Center and Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Keyerleber MA, Barber LG. Pilot study evaluating the tolerability of a 3 Gy × 10 daily fraction 3D-conformal palliative radiation therapy protocol plus toceranib for the treatment of measurable carcinomas in the dog. Vet Radiol Ultrasound 2022; 63:798-806. [PMID: 35969240 DOI: 10.1111/vru.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/19/2022] [Accepted: 05/21/2022] [Indexed: 11/29/2022] Open
Abstract
The use of radiation therapy in conjunction with small molecule inhibitors is an appealing treatment combination for non-resectable carcinomas, which tend to be locally invasive with variable risk of locoregional metastasis. This prospective, pilot study aimed to evaluate the tolerability and adverse event profile of concurrent toceranib and palliative-intent radiation therapy (PRT) in dogs with measurable carcinoma and to secondarily evaluate short-term measurable tumor response. Fifteen dogs with measurable carcinoma received toceranib and 3D-conformal PRT in 3 Gy/fraction for 10 daily fractions. Adverse events were graded using standard schemes and tolerability was followed via quality-of-life questionnaires during the 12-week treatment period. Thirteen dogs (87%) experienced acute radiation toxicity, graded as severe in three dogs. All dogs experienced toceranib toxicity, graded as severe in one dog. Seven dogs (47%) completed the 12-week study protocol; four were withdrawn due to toxicity and/or associated poor quality of life and four developed progressive disease. Based on these preliminary results, this 3D-conformal chemoradiation protocol should be considered with caution and only with proper owner education on potential toxicity. More conformal treatment planning techniques or alternative protocols should be investigated for improved tolerability.
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Affiliation(s)
- Michele A Keyerleber
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Lisa G Barber
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
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Norquest CJ, Maitz CA, Keys DA, Moore M, Bryan JN, Ehling TJ, Lattimer JC, Flesner BK. Fracture rate and time to fracture in dogs with appendicular osteosarcoma receiving finely fractionated compared to coarsely fractionated radiation therapy: A single institution study. Vet Med Sci 2022; 8:1013-1024. [PMID: 35263506 PMCID: PMC9122396 DOI: 10.1002/vms3.782] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Radiation therapy (RT) is used for local pain alleviation in dogs with appendicular osteosarcoma (OS), especially among dogs that are poor surgical candidates for amputation. However, many historical reports of fractionated protocols lack time to fracture and fracture rates. OBJECTIVES The primary objectives of this retrospective study were to determine fracture rate and time to fracture of dogs receiving RT (coarse or fine fractionated) for appendicular OS. Secondary objectives were to evaluate tolerability and disease outcome measures. METHODS Fifty-one dogs that received RT as part of treatment for appendicular OS were available for evaluation. Forty-five received coarse fractionation (C-RT, 8 or 6 Gy per fraction protocols [C-RT8 or C-RT6]) while the remaining six received fine fractionation (F-RT). RESULTS The overall pathologic fracture rate was 37%. Pathologic fracture rate was significantly higher for dogs that received F-RT (5/6, 83%) compared to dogs that received C-RT (12/40, 30%, p = 0.021). In the 17 dogs that fractured, the overall median time to fracture was 57 days. For all dogs, the median progression free interval (PFI) and median overall survival time (OST) were 90 and 140 days, respectively. In a very small cohort of dogs (n = 7) treated with zoledronate and RT, fracture rate was 0% and extended survival times were noted. CONCLUSIONS In conclusion, C-RT is recommended over F-RT due to lower risk of pathologic fracture and similar PFI. Prospective evaluation of combined C-RT and zoledronate, especially for dogs with poor surgical candidacy, is warranted for the treatment of canine appendicular osteosarcoma.
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Affiliation(s)
| | | | | | - Melanie Moore
- Veterinary Health CenterUniversity of MissouriColumbiaMissouri
| | | | - Tara J. Ehling
- Veterinary Health Center at WentzvilleUniversity of MissouriWentzvilleMissouri
| | | | - Brian K. Flesner
- Veterinary Health CenterUniversity of MissouriColumbiaMissouri
- School of Veterinary MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvania
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Fan VC, Mayer MN, Sukut SL, Gustafson NR, Mauldin GN, Waldner CL. Retrospective survey of owners' experiences with palliative radiation therapy for pets. J Am Vet Med Assoc 2019; 253:307-314. [PMID: 30019997 DOI: 10.2460/javma.253.3.307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe animal owners' experiences with palliative radiation therapy (PRT) of pets and identify factors influencing satisfaction with their pets' treatment. DESIGN Retrospective, cross-sectional study. SAMPLE 118 owners of dogs, cats, or rabbits. PROCEDURES Medical records were searched to identify animals that underwent PRT between 2004 and 2013. Signalment, tumor-related data, and outcome information were recorded. Owners completed an electronic survey assessing satisfaction with treatment (ie, satisfaction with the decision for their pet to undergo PRT and indication that they would choose PRT for their pet again), expectations regarding PRT, and perceptions of their pets' quality of life (QOL) and signs of discomfort from acute adverse radiation effects. Additional data regarding practical aspects of treatment, pet death, communications with veterinarians, and owner demographics were collected. Variables were tested for association with measures of owner satisfaction. RESULTS 92 of 116 (79%) owners were satisfied with the decision to have their pets undergo PRT. Most (92/118 [78%]) owners reported their pet's QOL improved after PRT; these owners were significantly more likely to be satisfied than those who did not report improved QOL. Owners who perceived their pets had discomfort from adverse radiation effects (38/116 [33%]) were significantly less likely to be satisfied than owners who did not report this observation. Measures of satisfaction were not associated with patient survival time. Twenty-one of 118 (18%) owners indicated they expected PRT would cure their pet's tumor. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that short life expectancy should not deter recommendation of PRT for pets. Protocols that minimize risk of acute adverse effects may be advantageous. Veterinarians should attempt to ensure that owners understand the goals of PRT.
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Jeong SJ, Kim S, Park JG, Jung IH, Lee MN, Jeon S, Kweon HY, Yu DY, Lee SH, Jang Y, Kang SW, Han KH, Miller YI, Park YM, Cheong C, Choi JH, Oh GT. Prdx1 (peroxiredoxin 1) deficiency reduces cholesterol efflux via impaired macrophage lipophagic flux. Autophagy 2017; 14:120-133. [PMID: 28605287 PMCID: PMC5846566 DOI: 10.1080/15548627.2017.1327942] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Oxidative stress activates macroautophagy/autophagy and contributes to atherogenesis via lipophagic flux, a form of lipid removal by autophagy. However, it is not known exactly how endogenous antioxidant enzymes are involved in lipophagic flux. Here, we demonstrate that the antioxidant PRDX1 (peroxiredoxin 1) has a crucial role in the maintenance of lipophagic flux in macrophages. PRDX1 is more highly expressed than other antioxidant enzymes in monocytes and macrophages. We determined that Prdx1 deficiency induced excessive oxidative stress and impaired maintenance of autophagic flux in macrophages. Prdx1-deficient macrophages had higher intracellular cholesterol mass and lower cholesterol efflux compared with wild type. This perturbation in cholesterol homeostasis was due to impaired lipophagic cholesterol hydrolysis caused by excessive oxidative stress, resulting in the inhibition of free cholesterol formation and the reduction of NR1H3 (nuclear receptor subfamily 1, group H, member 3) activity. Notably, impairment of both lipophagic flux and cholesterol efflux was restored by the 2-Cys PRDX-mimics ebselen and gliotoxin. Consistent with this observation, apoe −/− mice transplanted with bone marrow from prdx1−/−apoe−/− mice had increased plaque formation compared with apoe−/− BM-transplanted recipients. This study reveals that PRDX1 is crucial to regulating lipophagic flux and maintaining macrophage cholesterol homeostasis against oxidative stress. We suggest that PRDX1-dependent control of oxidative stress may provide a strategy for treating atherosclerosis and autophagy-related human diseases.
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Affiliation(s)
- Se-Jin Jeong
- a Immune and Vascular Cell Network Research Center, National Creative Initiatives , Department of Life Sciences , Ewha Womans University , Seoul , Korea.,b Cardiovascular Division , Department of Medicine , Washington University School of Medicine , St. Louis , MO , USA
| | - Sinai Kim
- a Immune and Vascular Cell Network Research Center, National Creative Initiatives , Department of Life Sciences , Ewha Womans University , Seoul , Korea
| | - Jong-Gil Park
- c Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience & Biotechnology , Daejeon , Korea
| | - In-Hyuk Jung
- b Cardiovascular Division , Department of Medicine , Washington University School of Medicine , St. Louis , MO , USA
| | - Mi-Ni Lee
- a Immune and Vascular Cell Network Research Center, National Creative Initiatives , Department of Life Sciences , Ewha Womans University , Seoul , Korea
| | - Sejin Jeon
- a Immune and Vascular Cell Network Research Center, National Creative Initiatives , Department of Life Sciences , Ewha Womans University , Seoul , Korea
| | - Hyae Yon Kweon
- a Immune and Vascular Cell Network Research Center, National Creative Initiatives , Department of Life Sciences , Ewha Womans University , Seoul , Korea
| | - Dae-Yeul Yu
- d Korea Aging Research Center, Korea Research Institute of Bioscience and Biotechnology , Daejeon , Korea
| | - Sang-Hak Lee
- e Division of Cardiology , Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Korea
| | - Yangsoo Jang
- e Division of Cardiology , Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Korea
| | - Sang Won Kang
- f Department of Life Science and Research Center for Cell Homeostasis , Ewha Womans University , Seoul , Korea ; Global Top5 Research program, Ewha Womans University , Seoul , Korea
| | - Ki-Hwan Han
- g Department of Anatomy , School of Medicine, Ewha Womans University , Seoul , Korea
| | - Yury I Miller
- h Department of Medicine , University of California, San Diego , San Diego , CA , USA
| | - Young Mi Park
- i Department of Molecular Medicine , Ewha Womans University School of Medicine , Seoul , Korea
| | - Cheolho Cheong
- j Department of Microbiology and Immunology , McGill Faculty of Medicine , Montréal , Canada
| | - Jae-Hoon Choi
- k Department of Life Science , College of Natural Sciences and Research Institute for Natural Sciences, Hanyang University , Seoul , Korea
| | - Goo Taeg Oh
- a Immune and Vascular Cell Network Research Center, National Creative Initiatives , Department of Life Sciences , Ewha Womans University , Seoul , Korea
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Dressel S, Gosselin MC, Capstick MH, Carrasco E, Weyland MS, Scheidegger S, Neufeld E, Kuster N, Bodis S, Rohrer Bley C. Novel hyperthermia applicator system allows adaptive treatment planning: Preliminary clinical results in tumour-bearing animals. Vet Comp Oncol 2017; 16:202-213. [PMID: 28892246 DOI: 10.1111/vco.12340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/14/2017] [Accepted: 07/17/2017] [Indexed: 11/28/2022]
Abstract
Hyperthermia (HT) as an adjuvant to radiation therapy (RT) is a multimodality treatment method to enhance therapeutic efficacy in different tumours. High demands are placed on the hardware and treatment planning software to guarantee adequately planned and applied HT treatments. The aim of this prospective study was to determine the effectiveness and safety of the novel HT system in tumour-bearing dogs and cats in terms of local response and toxicity as well as to compare planned with actual achieved data during heating. A novel applicator with a flexible number of elements and integrated closed-loop temperature feedback control system, and a tool for patient-specific treatment planning were used in a combined thermoradiotherapy protocol. Good agreement between predictions from planning and clinical outcome was found in 7 of 8 cases. Effective HT treatments were planned and verified with the novel system and provided improved quality of life in all but 1 patient. This individualized treatment planning and controlled heat exposure allows adaptive, flexible and safe HT treatments in palliatively treated animal patients.
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Affiliation(s)
- S Dressel
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | | | - M S Weyland
- ZHAW School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - S Scheidegger
- ZHAW School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - E Neufeld
- IT'IS Foundation, Zurich, Switzerland
| | - N Kuster
- IT'IS Foundation, Zurich, Switzerland.,Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - S Bodis
- Radioonkologie Zentrum KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland.,Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - C Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Pagano C, Boudreaux B, Shiomitsu K. SAFETY AND TOXICITY OF AN ACCELERATED COARSELY FRACTIONATED RADIATION PROTOCOL FOR TREATMENT OF APPENDICULAR OSTEOSARCOMA IN 14 DOGS: 10 GY × 2 FRACTIONS. Vet Radiol Ultrasound 2016; 57:551-6. [PMID: 27374864 DOI: 10.1111/vru.12389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 05/11/2016] [Indexed: 01/21/2023] Open
Abstract
Coarsely fractionated radiation is commonly used as a method for pain control in dogs with appendicular osteosarcoma, however there is little published information on optimal protocols. The aim of this retrospective, descriptive study was to report safety and toxicity findings in a sample of dogs with appendicular osteosarcoma that had been treated with a radiation scheme of 10 Gy delivered over two consecutive days for a total of 20 Gy. Dogs were included in the study if they had osteosarcoma that was treated with the aforementioned protocol. Dogs were excluded if treated with the same protocol for any other bone tumor besides osteosarcoma or inadequate follow-up. Thirteen of the 14 patients received adjuvant therapy with pamidronate and a nonsteroidal anti-inflammatory. Nine dogs received adjuvant chemotherapy with carboplatin after radiation was complete. Within a median of 14 days, 92.8% of dogs subjectively had improved pain control. Median duration of response (DOR) was 80 days (range 20-365). The majority of patients developed VRTOG grade one toxicity, primarily alopecia. Five dogs (35.7%) developed pathologic fracture postradiation treatment. Timing of fracture was variable ranging from 24 to 250 days. This radiation protocol was well tolerated, with minimal toxicity, subjectively improved survival time, and had the benefit of being completed in two consecutive days.
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Affiliation(s)
- Candace Pagano
- Department of Veterinary Clinical Sciences, Louisiana State University, Skip Bertman Dr., Baton Rouge, LA, 70803.
| | - Bonnie Boudreaux
- Department of Veterinary Clinical Sciences, Louisiana State University, Skip Bertman Dr., Baton Rouge, LA, 70803
| | - Keijiro Shiomitsu
- Department of Veterinary Clinical Sciences, Louisiana State University, Skip Bertman Dr., Baton Rouge, LA, 70803
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10
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Tollett MA, Duda L, Brown DC, Krick EL. Palliative radiation therapy for solid tumors in dogs: 103 cases (2007–2011). J Am Vet Med Assoc 2016; 248:72-82. [DOI: 10.2460/javma.248.1.72] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Cancedda S, Marconato L, Meier V, Laganga P, Roos M, Leone VF, Rossi F, Bley CR. HYPOFRACTIONATED RADIOTHERAPY FOR MACROSCOPIC CANINE SOFT TISSUE SARCOMA: A RETROSPECTIVE STUDY OF 50 CASES TREATED WITH A 5 × 6 GY PROTOCOL WITH OR WITHOUT METRONOMIC CHEMOTHERAPY. Vet Radiol Ultrasound 2015; 57:75-83. [PMID: 26551348 DOI: 10.1111/vru.12308] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 07/28/2015] [Accepted: 08/11/2015] [Indexed: 01/15/2023] Open
Abstract
Wide surgical resection or a marginal/incomplete resection followed by full-course radiation therapy is the current standard of care for canine soft tissue sarcoma. The purpose of this retrospective, descriptive, bi-institutional study was to determine the effectiveness and toxicity of a hypofractionated 5 × 6 Gy protocol on macroscopic canine soft tissue sarcoma in terms of progression-free interval (PFI) and overall survival (OS), and to identify prognostic factors for patient outcome. Dogs with macroscopic soft tissue sarcoma irradiated with 5 × 6 Gy were eligible for the study. Progression-free interval and OS were compared with respect to different tumor and patient characteristics by the Kaplan-Meier method and multivariable Cox regression analysis. Fifty dogs with macroscopic disease were included. All dogs received the same radiation therapy protocol; part of the group (n = 20) received postradiation metronomic chemotherapy. Median PFI for all cases was 419 days (95% confidence interval (CI): 287-551) and median OS was 513 days (95% CI: 368-658). Dogs with tumors on the limbs had significantly longer PFI and OS, compared with head or trunk. Increasing tumor burden decreased OS. The addition of metronomic chemotherapy yielded a significantly longer OS (757 days (95% CI: 570-944) compared with dogs that did not receive systemic treatment (286 days (95% CI: 0-518), (P = 0.023)), but did not influence progression-free interval. Toxicity was low throughout all treatments. The 5 × 6 Gy radiation therapy protocol was well tolerated and provided long PFI and OS in dogs with macroscopic soft tissue sarcoma.
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Affiliation(s)
- Simona Cancedda
- Centro Oncologico Veterinario, 40037, Sasso Marconi (BO), Italy
| | - Laura Marconato
- Centro Oncologico Veterinario, 40037, Sasso Marconi (BO), Italy
| | - Valeria Meier
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, CH-8057, Zurich, Switzerland
| | - Paola Laganga
- Centro Oncologico Veterinario, 40037, Sasso Marconi (BO), Italy
| | - Malgorzata Roos
- Division of Biostatistics, Epidemiology Biostatistics and Prevention Institute, Faculty of Medicine, University of Zurich, CH-8001, Zürich, Switzerland
| | - Vito F Leone
- Centro Oncologico Veterinario, 40037, Sasso Marconi (BO), Italy
| | - Federica Rossi
- Centro Oncologico Veterinario, 40037, Sasso Marconi (BO), Italy
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, CH-8057, Zurich, Switzerland
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Abstract
Pain is a widespread clinical symptom in companion animals with cancer, and its aggressive management should be a priority. Education and skills can be acquired by health care professionals and caregivers to better understand, recognize, and treat cancer-associated pain. The early and rational institution of multimodality analgesic protocols can be highly effective and maximize the chances of improving quality of life in dogs and cats with cancer. This article describes the pathophysiology of pain in companion animals diagnosed with cancer. The foundational causes of cancer-associated pain and treatment strategies for alleviating discomfort in companion animals with cancer are discussed.
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Tan-Coleman B, Lyons J, Lewis C, Rosenberg M, Ruiz A. Prospective evaluation of a 5 × 4 Gy prescription for palliation of canine nasal tumors. Vet Radiol Ultrasound 2012; 54:89-92. [PMID: 23002718 DOI: 10.1111/j.1740-8261.2012.01984.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 08/06/2012] [Indexed: 10/27/2022] Open
Abstract
We evaluated the efficacy of palliative radiation therapy using 5 × 4 Gy given daily in 18 dogs with nasal tumors. Dogs with malignant nasal tumors were evaluated for response rate, response duration, and survival. Seventy-eight percent of the dogs achieved complete resolution of clinical signs, and 16.5% had partial resolution of their signs. Overall median response duration for all dogs was 178 days after one course of radiation therapy. Six dogs received a second course of therapy when their disease progressed using the same daily 5 × 4 Gy scheme, and all six responded for a median time of 129.5 days for an overall median survival time in these six dogs of 309 days. Based on these results, a radiation prescription of 5 × 4 Gy appears to be useful palliatively in dogs with a malignant nasal tumor.
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McDonald C, Looper J, Greene S. Response rate and duration associated with a 4Gy 5 fraction palliative radiation protocol. Vet Radiol Ultrasound 2011; 53:358-64. [PMID: 22182209 DOI: 10.1111/j.1740-8261.2011.01907.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 11/11/2011] [Indexed: 12/01/2022] Open
Abstract
The purpose of this retrospective study was to determine if 4Gy fractions over 5 consecutive days is an effective and safe palliative radiation protocol for dogs and cats. Eighty patients (22 cats, 58 dogs) with complete follow-up information were evaluated. Overall response rate (ORR) for all patients was 67%. Median progression free survival (MPFS) was 3.3 months and median survival (MST) was 4.2 months. Primary bone tumors were the most common tumors treated. The ORR for primary bone tumors was 66.6%, the MPFS was 3.5 months, and MST was 3 months. The most common tumor treated in cats was oral squamous cell carcinoma and ORR was 54.5 %, the MPFS was 1.8 months, and MST was 3 months. Soft tissue sarcomas were the second most common tumor treated in dogs (10). ORR was 80% and the two other patients had stable disease. MPFS was 5.7 months and MST was 7.9 months. Overall rate of toxicity was 18.4% in 65 sites that were evaluated for toxicity. Acute toxicities were all grade I or II and occurred in 16.9 % of patients evaluated. All late toxicity was grade I alopecia and leukotrichia. There appears to be a comparable response rate for this palliative protocol as compared to others historically. This response was seen over a wide range of tumors. We also documented a low toxicity profile in a shorter overall treatment time, making this protocol more attractive for some clients.
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Morello E, Martano M, Buracco P. Biology, diagnosis and treatment of canine appendicular osteosarcoma: Similarities and differences with human osteosarcoma. Vet J 2011; 189:268-77. [DOI: 10.1016/j.tvjl.2010.08.014] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Revised: 08/12/2010] [Accepted: 08/28/2010] [Indexed: 10/19/2022]
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Buchholz J, Hagen R, Leo C, Ebling A, Roos M, Kaser-Hotz B, Bley CR. 3D conformal radiation therapy for palliative treatment of canine nasal tumors. Vet Radiol Ultrasound 2010; 50:679-83. [PMID: 19999357 DOI: 10.1111/j.1740-8261.2009.01603.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We evaluated the response of 38 dogs treated with a coarsely fractionated, palliative radiation protocol based on CT-based 3D treatment planning. Dogs with histologically confirmed malignant nasal tumors were studied. Treatment prescriptions consisted of 3-4 x 8 Gy, 4-5 x 6 Gy, or 10 x 3 Gy fractions. Selected patient and tumor factors were evaluated for an effect on outcome. Resolution of clinical signs was reported after irradiation in all dogs. Acute toxicities were mild and short lived. Thirty-seven of 38 dogs died or were euthanized due to tumor-related disease. Overall median progression-free interval (PFI) was 10 months. Tumor stage affected response, with modified stage 1 patients having a median PFI 21.3 months vs. a median PFI of 8.5 months for modified stage 2 patients (P = 0.0006). Modified stage was the only factor significantly related to outcome. Based on these findings, a palliative radiation prescription based on computerized treatment planning may be justified in some canine nasal tumor patients.
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Affiliation(s)
- Julia Buchholz
- Section of Radiation Oncology, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland
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Böttcher P, Krastel D, Hierholzer J, Westphalen K, Florian S, Hildebrandt G, Vera G, Oechtering G. Percutaneous cementoplasty in the palliative, multimodal treatment of primary bone tumors of the distal aspect of the radius in four dogs. Vet Surg 2009; 38:888-901. [PMID: 19781033 DOI: 10.1111/j.1532-950x.2009.00596.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To (1) evaluate the analgesic effect of percutaneous cementoplasty (PC) in dogs with primary bone tumor (PBT) of the distal aspect of the radius and (2) evaluate the impact on the course of disease by adding PC to a palliative, multimodal treatment protocol in these dogs. STUDY DESIGN Prospective pilot study. ANIMALS Dogs (n=4) with PBT of the distal aspect of the radius. METHODS Tumor lesions were filled percutaneously with polymethylmethacrylate under fluoroscopic guidance. Pamidronate was administered once in a week before PC. Radiotherapy and chemotherapy were initiated 2 and 6 weeks after PC, respectively. Force plate analysis was performed immediately before 2, and 6 weeks after PC. Survival time was defined from PC to euthanasia. RESULTS Two dogs had a significant increase in peak vertical force 2 weeks after PC (P=.043) and remained free of lameness for 18 and 20 weeks, respectively. One dog had an acute relapse after an initially lame-free period of 10 days. The remaining dog failed to improve (P=.686). Three dogs developed at least 2 complications including transient worsening of the lameness after PC, cement leakage, wound infection and suspected thromboembolism in combination with cough and anemia. Median survival was 4.8 months (range, 1-5.7 months). CONCLUSIONS PC in combination with pamidronate significantly improved lameness in 2 dogs; however, PC is not risk-free. Deep wound infection, intraarticular cement leakage, and venous thrombosis were the main complications. CLINICAL RELEVANCE PC might be a useful addition to established palliative, multimodal treatment protocols in dogs with PBT; however, because of the complications encountered PC warrants further study before routine use can be considered.
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Affiliation(s)
- Peter Böttcher
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, Leipzig, Germany.
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Denneberg NÅ, Egenvall A. Evaluation of dog owners' perceptions concerning radiation therapy. Acta Vet Scand 2009; 51:19. [PMID: 19402904 PMCID: PMC2687441 DOI: 10.1186/1751-0147-51-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Accepted: 04/29/2009] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND External radiation therapy (RT) has been available for small animals in Sweden since 2006. This study was designed to obtain information on owner experiences and perceptions related to RT of cancer in their dogs. Another survey was used to determine the attitudes about use of RT in a group of Swedish veterinarians. Their responses were analyzed and compared to their level of knowledge of oncology and RT. METHODS Owners of all dogs (n = 23) who had undergone RT for malignancy at Jönköping Small Animal Hospital between March 2006 to September 2007 were interviewed. A questionnaire was given to a selected group of veterinarians. RESULTS All 23 owners responded. All owners thought that their dog did well during RT and most that their dog was also fine during the following phase when acute RT-related skin reactions occur and heal. Three owners stated that their dog had pain that negatively impacted quality of life because of radiation dermatitis. Five owners reported that RT positively impacted quality of life of the dog during the first weeks after RT because palliation was achieved. The owners were not disturbed by the efforts required of them. All but one owner (22 of 23) stated that they would make the same decision about RT again if a similar situation occurred. The most important factor for this decision was the chance to delay occurrence of tumour-related discomfort. The chance for cure was of less importance but still essential, followed by expected side effects. Time commitments, travel, number of treatments required and financial cost; all had low impact. The veterinarian survey showed that less background knowledge of small animal oncology/RT was associated with more negative expectations of RT for small animals. CONCLUSION The results show that for these owners, RT was a worthwhile treatment modality and that the discomfort for the dog was manageable and acceptable relative to the benefits. Improved continuing education about small animal RT in Sweden will likely result in increased evidence-based and positive treatment recommendations concerning RT by veterinarians.
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Affiliation(s)
| | - Agneta Egenvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
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Coomer A, Farese J, Milner R, Liptak J, Bacon N, Lurie D. Radiation therapy for canine appendicular osteosarcoma. Vet Comp Oncol 2009; 7:15-27. [DOI: 10.1111/j.1476-5829.2008.00177.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Knapp-Hoch HM, Fidel JL, Sellon RK, Gavin PR. An Expedited Palliative Radiation Protocol for Lytic or Proliferative Lesions of Appendicular Bone in Dogs. J Am Anim Hosp Assoc 2009; 45:24-32. [DOI: 10.5326/0450024] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fifty-eight dogs with lytic or proliferative bone lesions were treated with a radiation protocol of two 8-Gy fractions over 2 consecutive days. The protocol was well tolerated, with no increase in early or late effects over previously published protocols. Forty-three (91%) of 47 dogs responded positively to radiation, with a median time of 2 days to onset of pain relief. Median duration of pain relief was 67 days (range 12 to 503 days; mean 99±16 days). Median survival time for all dogs was 136 days (mean 179±18 days). Distal radial location was a positive prognostic indicator for survival (P=0.005).
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Affiliation(s)
- Heather M. Knapp-Hoch
- Department of Clinical Sciences (Knapp-Hoch), College of Veterinary Medicine, Cornell University, Ithaca, New York 14853 and the Department of Veterinary Clinical Sciences (Fidel, Sellon, Gavin), College of Veterinary Medicine, Washington State University, Pullman, Washington 99164-6610
- From the
| | - Janean Louise Fidel
- Department of Clinical Sciences (Knapp-Hoch), College of Veterinary Medicine, Cornell University, Ithaca, New York 14853 and the Department of Veterinary Clinical Sciences (Fidel, Sellon, Gavin), College of Veterinary Medicine, Washington State University, Pullman, Washington 99164-6610
- From the
| | - Rance K. Sellon
- Department of Clinical Sciences (Knapp-Hoch), College of Veterinary Medicine, Cornell University, Ithaca, New York 14853 and the Department of Veterinary Clinical Sciences (Fidel, Sellon, Gavin), College of Veterinary Medicine, Washington State University, Pullman, Washington 99164-6610
- From the
| | - Patrick R. Gavin
- Department of Clinical Sciences (Knapp-Hoch), College of Veterinary Medicine, Cornell University, Ithaca, New York 14853 and the Department of Veterinary Clinical Sciences (Fidel, Sellon, Gavin), College of Veterinary Medicine, Washington State University, Pullman, Washington 99164-6610
- From the
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21
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Lawrence J, Forrest L, Adams W, Vail D, Thamm D. Four-fraction radiation therapy for macroscopic soft tissue sarcomas in 16 dogs. J Am Anim Hosp Assoc 2008; 44:100-8. [PMID: 18451067 DOI: 10.5326/0440100] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A retrospective study of 16 dogs with macroscopic soft tissue sarcomas was performed to evaluate response to a four-fraction radiotherapy protocol (prescribed dose of 32 Gy). Radiation was well tolerated with minimal side effects. The overall response rate was 50%, with seven partial responses and one complete response. The median time to progression was 155 days, and the median survival time was 309 days. Coarsely fractionated radiation therapy may be a reasonable palliative option for dogs with unresectable soft tissue sarcomas, although the response is relatively short-lived.
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Affiliation(s)
- Jessica Lawrence
- Departments of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, Wisconsin 53706, USA
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22
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Gieger T, Rassnick K, Siegel S, Proulx D, Bergman P, Anderson C, LaDue T, Smith A, Northrup N, Roberts R. Palliation of clinical signs in 48 dogs with nasal carcinomas treated with coarse-fraction radiation therapy. J Am Anim Hosp Assoc 2008; 44:116-23. [PMID: 18451069 DOI: 10.5326/0440116] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Data from 48 dogs with nasal carcinomas treated with palliative radiation therapy (PRT) were retrospectively reviewed. Factors potentially influencing resolution of clinical signs and survival after PRT were evaluated. Clinical signs completely resolved in 66% of dogs for a median of 120 days. The overall median survival time was 146 days. Duration of response to PRT was shorter in dogs that had clinical signs for <90 days before PRT. Survival times were shorter in dogs that had partial or no resolution of clinical signs after PRT than in dogs that had complete resolution of clinical signs.
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Affiliation(s)
- Tracy Gieger
- Department of Clinical Sciences, Cornell University Hospital for Animals, CPC Box 31, Tower Road, Ithaca, New York 14853, USA
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23
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24
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Affiliation(s)
- Janina I Wojciechowska
- Sir James Dunn Animal Welfare Centre, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada C1A 4P3
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25
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Yazbek KVB, Fantoni DT. Validity of a health-related quality-of-life scale for dogs with signs of pain secondary to cancer. J Am Vet Med Assoc 2005; 226:1354-8. [PMID: 15844428 DOI: 10.2460/javma.2005.226.1354] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To develop and validate a health-related quality-of-life scale for dogs with pain secondary to cancer. DESIGN Questionnaire development. ANIMALS 40 healthy dogs with no history or signs of pain, 20 dogs with dermatologic disease but no signs of pain other than mild pruritus, and 20 dogs with cancer. PROCEDURE Owners of all dogs completed a questionnaire containing 12 questions with 4 options for each question, and a quality-of-life score ranging from 0 to 36 was calculated. Scores for dogs with cancer were compared with scores for healthy dogs and dogs with dermatologic disease. RESULTS All owners indicated that the questionnaire was easy to complete. Scores for healthy dogs were significantly different from scores for dogs with cancer and scores for dogs with dermatologic disease. Scores for dogs with dermatologic disease were significantly different from scores for dogs with cancer. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that a simple questionnaire may be useful in assessing health-related quality of life in dogs with pain secondary to cancer, in that dogs with cancer had significantly lower scores than did healthy dogs and dogs with dermatologic disease.
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Affiliation(s)
- Karina V B Yazbek
- Department of Surgery, School of Veterinary Medicine, Universidade de São Paulo, Avenida Professor Doutor Orlando Marques de Paiva 87, cep 05508-900, Butantã, São Paulo-SP, Brazil
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26
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Fan TM, Lorimier LP, Charney SC, Hintermeister JG. Evaluation of Intravenous Pamidronate Administration in 33 Cancer-Bearing Dogs with Primary or Secondary Bone Involvement. J Vet Intern Med 2005. [DOI: 10.1111/j.1939-1676.2005.tb02661.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Mellanby RJ, Herrtage ME, Chantry J, Dobson JM. Sarcoma development after radiotherapy in two dogs. Vet Comp Oncol 2003; 1:113-9. [DOI: 10.1046/j.1476-5829.2003.00014.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Chun R, de Lorimier LP. Update on the biology and management of canine osteosarcoma. Vet Clin North Am Small Anim Pract 2003; 33:491-516, vi. [PMID: 12852233 DOI: 10.1016/s0195-5616(03)00021-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Osteosarcoma (OSA) is the most common primary bone tumor diagnosed in dogs. Our understanding of the risk factors and genetic changes in canine OSA patients is growing, but specific, innovative therapeutic strategies are slow in coming. Appendicular skeletal osteosarcoma, the most frequent form of this disease, is typically seen in large to giant breeds, with males being overrepresented in most reports. Axial skeletal OSA is less common than appendicular OSA, but the biologic behavior of the disease is equally aggressive in all skeletal sites except for the mandible. Though the current standard of care for dogs with osteosarcoma remains surgical resection of the affected site, followed by chemotherapy with either a platinum- (cisplatin or carboplatin) or doxorubicin-based protocol, novel therapies are being actively investigated.
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Affiliation(s)
- Ruthanne Chun
- Kansas State University College of Veterinary Medicine, Mosier Hall, 1800 Denison Avenue, Manhattan, KS 66506-5606, USA.
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29
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Farrelly J, McEntee MC. Principles and applications of radiation therapy. CLINICAL TECHNIQUES IN SMALL ANIMAL PRACTICE 2003; 18:82-7. [PMID: 12831066 DOI: 10.1053/svms.2003.36620] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiation therapy is emerging as a beneficial and increasingly accessible treatment option for companion animals with cancer. Various types of radiation are available with different properties that may make one more suitable than another for treating a specific tumor type. Radiation therapy can be used as the sole treatment or as part of a multimodality treatment course to result in local or locoregional tumor control, or as palliative therapy for pain control. When radiation is a potential treatment option, it should be considered early in the decision-making process to ensure that the appropriate diagnostics and other treatment modalities are considered to provide the best potential outcome. This article is intended to provide an overview of the types of radiation therapy that are available, the indications, and the potential acute and late radiation side effects.
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Affiliation(s)
- John Farrelly
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
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30
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Mellanby RJ, Herrtage ME, Dobson JM. Owners' assessments of their dog's quality of life during palliative chemotherapy for lymphoma. J Small Anim Pract 2003; 44:100-3. [PMID: 12653322 DOI: 10.1111/j.1748-5827.2003.tb00127.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The owners of 25 dogs with multicentric lymphoma which were treated by multidrug chemotherapy were interviewed to assess the quality of their pet's life during treatment. Sixty-eight per cent of the owners considered their dog's quality of life to be the same as before the lymphoma occurred, and the remaining 32 per cent felt that their pet's quality of life on chemotherapy treatment was acceptable but poorer than before the lymphoma occurred. Treatment complications were reported by 52 per cent of owners. Ninety-two per cent of owners had no regrets about treating their dog with multidrug chemotherapy. The results suggest that, while many dogs developed treatment complications during multidrug chemotherapy, most owners felt that the quality of life of their pets was good during treatment and had no regrets about opting for palliative chemotherapy.
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Affiliation(s)
- R J Mellanby
- Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES
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31
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Green EM, Adams WM, Forrest LJ. Four fraction palliative radiotherapy for osteosarcoma in 24 dogs. J Am Anim Hosp Assoc 2002; 38:445-51. [PMID: 12220029 DOI: 10.5326/0380445] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Twenty-four dogs underwent palliative radiotherapy consisting of four 8 gray (Gy) fractions of 60Co radiation on days 0, 7, 14, and 21 at 26 sites for axial (n=11) or appendicular (n=15) osteosarcoma. Response was noted in 92% of sites treated. Seventeen dogs were euthanized due to local or metastatic disease, one dog died of metastatic disease, five dogs died of unrelated causes, and one dog is alive. The four fraction protocol is effective for palliation of clinical signs associated with axial or appendicular osteosarcoma and may result in a higher response rate and longer survival time than three fraction palliative protocols.
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Affiliation(s)
- Eric M Green
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 53706, USA
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32
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Goodrich LR, Nixon AJ, Fubini SL, Ducharme NG, Fortier LA, Warnick LD, Ludders JW. Epidural morphine and detomidine decreases postoperative hindlimb lameness in horses after bilateral stifle arthroscopy. Vet Surg 2002; 31:232-9. [PMID: 11994850 DOI: 10.1053/jvet.2002.32436] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine whether preoperative epidural administration of morphine and detomidine would decrease postoperative lameness after bilateral stifle arthroscopy in horses. STUDY DESIGN Prospective clinical controlled study. ANIMALS Eight adult horses that had bilateral arthroscopic procedures, including drilling of cartilage and subchondral bone within the femoropatellar joints. METHODS Horses were randomly separated into 2 groups. Preoperatively, 4 horses were administered a combination of epidural morphine (0.2 mg/kg) and detomidine (30 microg/kg), and 4 horses were administered an equivalent volume of epidural saline (0.9% NaCl) solution. Postoperative pain was assessed using 6 video recordings made at hourly intervals of each horse at a walk. Assessments began 1 hour after recovery from anesthesia. The recordings were scrambled out of sequence and evaluated by 3 observers, unaware of treatment groups, who scored lameness from 0 to 4. Lameness scores of the 2 groups of horses were compared using a Wilcoxon's rank sum test. Heart and respiratory rates were also measured at each hourly interval and compared between groups using a repeated-measures ANOVA; statistical significance was set at P <.05. RESULTS Preoperative administration of epidural morphine and detomidine significantly decreased lameness and heart rates after bilateral stifle arthroscopy. The greatest decrease was detected at hours 1 and 2 after recovery from anesthesia. CONCLUSION We conclude that horses undergoing a painful arthroscopic procedure of the stifle joint benefit from the administration of preoperative epidural morphine and detomidine. CLINICAL RELEVANCE Preoperative epidural administration of detomidine and morphine may be useful in decreasing postoperative pain after stifle arthroscopy as well as pain associated with other painful disorders involving the stifle joint, such as septic arthritis and trauma.
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Affiliation(s)
- Laurie R Goodrich
- Cornell University, College of Veterinary Medicine, Ithaca, NY 14853, USA
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33
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Mellanby RJ, Herrtage ME, Dobson JM. Owners’ assessments of their dog's quality of life during palliative chemotherapy for lymphoma. J Small Anim Pract 2002. [DOI: 10.1111/j.1748-5827.2002.tb00037.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R. J. Mellanby
- Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES
| | - M. E. Herrtage
- Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES
| | - J. M. Dobson
- Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES
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Ramirez O, Dodge RK, Page RL, Price GS, Hauck ML, LaDue TA, Nutter F, Thrall DE. Palliative radiotherapy of appendicular osteosarcoma in 95 dogs. Vet Radiol Ultrasound 1999; 40:517-22. [PMID: 10528848 DOI: 10.1111/j.1740-8261.1999.tb00385.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Ninety-five dogs with either a presumptive (n = 24) or biopsy confirmed diagnosis (n = 71) of osteosarcoma received palliative radiotherapy using 60Co photons. Parallel opposed beams were used with each dog receiving either 10 Gy on days 0, 7 and 21 (n = 58) or 8 Gy on days 0 and 7 (n = 37). The 8 Gy fractionation scheme was given with the intent of retreating upon relapse from pain relief. Only 9 of 37 (24%) dogs in the 8 Gy group returned for retreatment. Forty-seven of the 95 dogs (49%) received concurrent or sequential chemotherapy. Seventy of the 95 dogs (74%) experienced pain relief following treatment. In dogs experiencing pain relief the median duration of response was 73 days. Numerous clinical variables were evaluated as predictors of response. The only variable significantly related to achieving a response was the use of chemotherapy. The following variables were significantly related to the duration of response: extent of bone lysis, chemotherapy use, length of bone involved and tumor site (humerus). In a multivariate analysis (n = 73 dogs), after adjusting for chemotherapy use, extent of bone involvement (p = 0.01) and tumor site (p = 0.02) retained statistical significance, while degree of bone lysis did not (p = 0.11). No difference in response incidence or duration was found between 3 fractions of 10 Gy vs. 2 fractions of 8 Gy. Administration of a low initial dose with the intent of retreatment was not a successful strategy.
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Affiliation(s)
- O Ramirez
- Department of Anatomy, Physiological Sciences and Radiology, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
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Brearley MJ, Jeffery ND, Phillips SM, Dennis R. Hypofractionated Radiation Therapy of Brain Masses in Dogs: A Retrospective Analysis of Survival of 83 Cases (1991-1996). J Vet Intern Med 1999. [DOI: 10.1111/j.1939-1676.1999.tb01454.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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36
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Brearley MJ, Hayes AM, Murphy S. Hypofractionated radiation therapy for invasive thyroid carcinoma in dogs: a retrospective analysis of survival. J Small Anim Pract 1999; 40:206-10. [PMID: 10385862 DOI: 10.1111/j.1748-5827.1999.tb03061.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thirteen dogs with invasive thyroid carcinoma (WHO classification T2b or T3b) seen between January 1991 and October 1997 were treated by external beam irradiation. Four once-weekly fractions of 9 gray of 4 MeV X-rays were administered. Four of the dogs died of progression of the primary disease and four from metastatic spread. Of the remaining dogs, three died of unrelated problems, although two were still alive at the time of the censor. Kaplan-Meier analysis of the survival time from first dose to death from either primary or metastatic disease gave a median survival time of 96 weeks (mean 85 weeks, range six to 247 weeks). Radiographic evidence of pulmonary metastatic disease at presentation had no prognostic value whereas crude growth rate was a highly significant factor. The present series indicates that radiation therapy should be considered an important modality for the control of invasive thyroid carcinoma in the dog.
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Affiliation(s)
- M J Brearley
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk
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37
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Kyles AE, Ruslander D. Chronic pain: osteoarthritis and cancer. SEMINARS IN VETERINARY MEDICINE AND SURGERY (SMALL ANIMAL) 1997; 12:122-32. [PMID: 9159069 DOI: 10.1016/s1096-2867(97)80009-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Osteoarthritis and cancer pain are two types of chronic pain commonly seen in small animal practice. The management of osteoarthritic pain consists of both pharmacologic therapy and nonpharmacologic strategies, including exercise control, dietary management and surgical therapy. Nonsteroidal antiinflammatory drugs are commonly used, although there is still controversy about their effect on the underlying pathologic processes of osteoarthritis. Despite a lack of well-designed clinical trials, chondroprotective drugs and neutraceuticals have gained popularity. Cancer pain can result from direct tumor invasion, paraneoplastic syndromes or diagnostic and therapeutic procedures, including surgery, chemotherapy and radiation. Treatment of cancer pain consists of definitive or palliative therapy and management of therapy induced pain. Analgesic therapy should be based on the World Health Organization's three step analgesic ladder for the administration of analgesia to cancer patients.
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Affiliation(s)
- A E Kyles
- North Carolina State University, College of Veterinary Medicine, Department of Companion Animal and Special Species Medicine, Raleigh, USA
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38
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Abstract
Radiation therapy is used in the management of both primary and metastatic bone tumors. The most common primary bone tumor in dogs and cats is osteosarcoma of the appendicular skeleton. A number of other primary bone tumors occur at a much lower rate in both species and include chondrosarcoma, fibrosarcoma, hemangiosarcoma, multiple myeloma, and lymphoma. This article reviews the results of published reports on the utility of radiation therapy in the treatment of primary and metastatic bone tumors of companion animals.
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Affiliation(s)
- M C McEntee
- Animal Medical Center, New York, New York, USA
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39
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Abstract
Palliative radiation therapy can be useful in controlling the pain associated with tumors for which definitive therapy is not an option. The patient's quality of life is improved while side effects, hospitalization, and cost of treatment are minimized. Palliative radiation therapy should be considered as part of the oncologist's armamentarium; however, further investigations are warranted to develop appropriate protocols based on patient response.
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Affiliation(s)
- S Siegel
- Angell Memorial Animal Hospital, Boston, Massachusetts, USA
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