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A Combined Hypofractionated Volumetric Modulated Arc Radiotherapy, Radio-Sensitising and Adjuvant Metronomic Chemotherapy Treatment for Canine Stage IV Nasal Tumours With Intracranial Extension. Top Companion Anim Med 2022; 51:100737. [DOI: 10.1016/j.tcam.2022.100737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/30/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
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Meier V, Staudinger C, Körner M, Soukup A, Rohrer Bley C. Dose-escalated simultaneously integrated boost radiation protocol fails to result in a survival advantage for sinonasal tumors in dogs. Vet Radiol Ultrasound 2022; 63:633-648. [PMID: 35347801 PMCID: PMC9790663 DOI: 10.1111/vru.13086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/30/2022] Open
Abstract
The prognosis for canine sinonasal tumors remains rather poor despite definitive-intent radiotherapy (RT). Theoretical calculations predicted improved outcomes with simultaneously integrated boost (SIB) protocols. With the hypothesis of clinically detectable differences in outcome between groups, our retrospective study evaluated prognostic variables and outcome in dogs treated with regular versus SIB RT. Dogs with sinonasal tumors treated with either a regular (10 × 4.2 Gy) or new SIB protocol (10 × 4.83 Gy to macroscopic tumor) were included. Information regarding signalment, tumor stage, type, clinical signs, radiation toxicity, response, and outcome was collected. Forty-nine dogs were included: 27 treated regularly and 22 treated with SIB RT. A total of 69.4% showed epistaxis, 6.1% showed epileptic seizures, 46.9% showed stage IV tumors, and 6.1% showed lymph node metastases. Early toxicity was mostly mild. Late grade 1 skin toxicity (alopecia/leucotrichia) was seen in 72.1% of dogs, and a possible grade 3 ocular toxicity (blindness) was seen in one dog. Complete/partial resolution of clinical signs was seen in 95.9% of patients as best clinical response and partial remission was seen as best imaging response in 34.7%. The median progression-free survival (PFS) was 274 days (95% CI: 117-383) for regular and 300 days (95% CI: 143-451) for SIB RT, which was not significantly different (P = 0.42). Similarly, the median overall survival (OS) was 348 days (95% CI: 121-500) for regular and 381 days (95% CI: 295-634) for the SIB RT (P = 0.18). Stratified by protocol, the hazard ratio of stage IV versus stage I-III tumors was 2.29 (95% CI: 1.156-4.551, P = 0.02) for OS but not PFS. All dogs showed acceptable toxicity. In contrast to theoretical predictions, however, we could not show a statistically significant better outcome with the new protocol.
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Affiliation(s)
- Valeria Meier
- Division of Radiation Oncology, Department for Small Animals, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland,Department of PhysicsUniversity of ZurichZurichSwitzerland
| | - Chris Staudinger
- Division of Radiation Oncology, Department for Small Animals, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Maximilian Körner
- Division of Radiation Oncology, Department for Small Animals, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Alena Soukup
- Equinox Healthcare GmbHRadiation Therapy Center for Horses and Small AnimalsLinsengerichtGermany
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Department for Small Animals, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
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3
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Meier V, Czichon F, Walsh L, Rohrer Bley C. Can volumetric modulated arc radiation therapy reduce organ at risk dose in stage 4 sinonasal tumors in dogs treated with boost irradiation? PLoS One 2021; 16:e0259112. [PMID: 34714825 PMCID: PMC8555811 DOI: 10.1371/journal.pone.0259112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022] Open
Abstract
Intensity modulated radiation therapy (IMRT) introduced marked changes to cancer treatment in animals by reducing dose to organs at risk (OAR). As the next technological step, volumetric modulated arc therapy (VMAT) has advantages (increased degrees-of-freedom, faster delivery) compared to fixed-field IMRT. Our objective was to investigate a possible advantage of VMAT over IMRT in terms of lower OAR doses in advanced-disease sinonasal tumors in dogs treated with simultaneously-integrated boost radiotherapy. A retrospective, analytical, observational study design was applied using 10 pre-existing computed tomography datasets on dogs with stage 4 sinonasal tumors. Each dataset was planned with both, 5-field IMRT and 2 arc VMAT with 10x4.83 Gy to the gross tumor volume and 10x4.2 Gy to the planning target volume. Adequate target dose coverage and normal tissue complication probability of brain ≤5% was required. Dose constraints aspired to were D60 <15 Gy for eyes, D2 <35.4 Gy for corneae, and Dmean <20 Gy for lacrimal glands. OAR dose was statistically significantly higher in IMRT plans than in VMAT plans. Median eye D60% was 18.5 Gy (interquartile range (IQR) 17.5) versus 16.1 Gy (IQR 7.4) (p = 0.007), median lacrimal gland dose 21.8 Gy (IQR 20.5) versus 18.6 Gy (IQR 7.0) (p = 0.013), and median cornea D2% 45.5 Gy (IQR 6.8) versus 39.9 Gy (IQR 10.0) (p<0.005) for IMRT versus VMAT plans, respectively. Constraints were met in 21/40 eyes, 7/40 corneae, and 24/40 lacrimal glands. Median delivery time was significantly longer for IMRT plans than for VMAT plans (p<0.01). Based on these results, VMAT plans were found to be superior in sparing doses to eyes, lacrimal glands, corneae. However, not all ocular OAR constraints could be met while ensuring adequate dose coverage and restricting brain toxicity risk for both planning techniques.
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Affiliation(s)
- Valeria Meier
- Vetsuisse Faculty, Department for Small Animals, Division of Radiation Oncology, University of Zurich, Zurich, Switzerland
- Department of Physics, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - Felicitas Czichon
- Vetsuisse Faculty, Department for Small Animals, Division of Radiation Oncology, University of Zurich, Zurich, Switzerland
| | - Linda Walsh
- Department of Physics, University of Zurich, Zurich, Switzerland
| | - Carla Rohrer Bley
- Vetsuisse Faculty, Department for Small Animals, Division of Radiation Oncology, University of Zurich, Zurich, Switzerland
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4
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Yoshikawa H, Gieger TL, Saba CF, Fredrickson K, Kubicek L, Haney S, Ruslander D, Kelsey KL, McEntee MC, Nolan MW. Retrospective evaluation of intranasal carcinomas in cats treated with external-beam radiotherapy: 42 cases. J Vet Intern Med 2021; 35:1018-1030. [PMID: 33660305 PMCID: PMC7995428 DOI: 10.1111/jvim.16098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/07/2022] Open
Abstract
Background Little is known regarding the comparative efficacy of various irradiation strategies used to treat intranasal carcinomas (INC) in cats. Objectives Investigate outcomes and prognostic factors associated with survival for cats with INC. Animals Forty‐two cats with INC that underwent radiotherapy (RT). Methods Single‐arm retrospective study. Medical record review for cats with INC that underwent RT at 1 of 7 veterinary RT facilities. Irradiation protocols categorized as: definitive‐intent fractionated RT (FRT), definitive‐intent stereotactic RT (SRT), and palliative‐intent RT (PRT). Median overall survival time (OST) and disease progression‐free survival (PFS; documented by advanced transverse imaging, or recurrence of symptoms) were calculated. Associations between tumor stage, RT protocol/intent, and adjunctive treatment usage and outcome were calculated. Results Cats underwent SRT (N = 18), FRT (N = 8), and PRT (N = 16). In multivariate modeling, cats received definitive‐intent treatment (DRT; FRT/SRT) had significantly longer median PFS (504 days, [95% confidence interval (CI): 428–580 days] vs PRT 198 days [95% CI: 62–334 days]; p = 0.006) and median OST [721 days (95% CI: 527–915 days) vs 284 days (95% CI: 0–570 days); p = 0.001]). Cats that underwent second DRT course at time of recurrence lived significantly longer than cats that received 1 RT course (either DRT or PRT [median OST 824 days (95% CI: 237–1410 days) vs 434 days (95% CI: 277–591 days); p = .028]). Conclusion In cats with INC, DRT is associated with prolonged OST and PFS as compared to PRT. If tumor progression occurs, a second course of DRT should be considered.
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Affiliation(s)
- Hiroto Yoshikawa
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Tracy L Gieger
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Corey F Saba
- College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Kirsha Fredrickson
- College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | | | - Siobhan Haney
- Hope Veterinary Specialists, Malvern, Pennsylvania, USA
| | - David Ruslander
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Krista L Kelsey
- Carolina Veterinary Specialists, Matthews, North Carolina, USA
| | | | - Michael W Nolan
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
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5
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Mortier JR, Blackwood L. Treatment of nasal tumours in dogs: a review. J Small Anim Pract 2020; 61:404-415. [PMID: 32715503 DOI: 10.1111/jsap.13173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/25/2020] [Accepted: 05/07/2020] [Indexed: 01/14/2023]
Abstract
Nasal tumours are common neoplasms in dogs and often represent a diagnostic and therapeutic challenge due to their confined location within the nasal cavities. The main goal of this review is to extract the most relevant information from a wide and often confusing evidence-based medicine on the treatment of canine nasal tumours and conclude with current recommendations. This report highlights the different therapeutic modalities available and describes their technical aspects, interests and limitations. Megavoltage radiotherapy, as the most recent treatment and standard of care, is particularly examined, especially the different types of radiotherapy units, the main protocols used and their advantages and limits. Newer and non-conventional treatments are also discussed.
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Affiliation(s)
- J R Mortier
- Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Chester High Road, Neston, CH647TE, UK
| | - L Blackwood
- Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Chester High Road, Neston, CH647TE, UK
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Stevens A, Turek M, Vail D, Christensen N, Forrest L. Definitive-intent intensity modulated radiotherapy for modified-Adams' stage 4 canine sinonasal cancer: A retrospective study of 29 cases (2011-2017). Vet Radiol Ultrasound 2020; 61:718-725. [PMID: 32713101 DOI: 10.1111/vru.12899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/02/2020] [Accepted: 05/07/2020] [Indexed: 11/30/2022] Open
Abstract
Dogs with sinonasal tumors with cribriform plate lysis (modified Adams' stage 4) treated with non-conformal definitive radiotherapy (RT) have short median survivals of 6-7 months. Intensity-modulated radiotherapy with its greater conformality and tumor dose homogeneity may result in more favorable outcomes. Dogs with epithelial or mesenchymal sinonasal tumors and CT evidence of cribriform lysis that received 10 daily fractions of 4.2 Gray using IMRT by helical tomotherapy were included in this single-institution retrospective case series study. Dogs with distant metastasis, previous treatment, or concurrent chemotherapy were excluded. Based on CT, tumors were divided into two groups: cribriform plate lysis only (stage 4a) or intracranial extension (stage 4b). Twenty-nine dogs were included, 23 with carcinoma and six with sarcoma. Eight dogs had stage 4b tumors; two presented with neurologic signs. Two dogs had lymph node metastasis at diagnosis, one confirmed and one suspected. Radiation dose distributions were standardized and patient positioning for RT was verified daily using on-board megavoltage CT. All evaluable dogs had improvement of clinical signs. Median progression free survival was 177 days (95% CI, 128-294 days). Median overall survival was 319 days (95% CI, 188-499 days). Radiotherapy was well tolerated. The most common side effect was grade 1 or 2 oral mucositis. Two dogs that received additional treatment at progression (stereotactic RT [1]; surgery [1]) developed significant late effects. Image-guided definitive-intent IMRT may improve survival in dogs with modified Adams' stage 4 sinonasal tumors and is associated with low morbidity. Intracranial tumor extension was not prognostic in this cohort of uniformly treated dogs.
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Affiliation(s)
- Audrey Stevens
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Veterinary Specialty Hospital, San Diego, California, USA
| | - Michelle Turek
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - David Vail
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Neil Christensen
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Small Animal Specialist Hospital, North Ryde, Sydney, Australia
| | - Lisa Forrest
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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7
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Nell E, Ober C, Rendahl A, Forrest L, Lawrence J. Volumetric tumor response assessment is inefficient without overt clinical benefit compared to conventional, manual veterinary response assessment in canine nasal tumors. Vet Radiol Ultrasound 2020; 61:592-603. [PMID: 32702179 DOI: 10.1111/vru.12895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/27/2020] [Accepted: 05/07/2020] [Indexed: 02/04/2023] Open
Abstract
Accurate assessment of tumor response to therapy is critical in guiding management of veterinary oncology patients and is most commonly performed using response evaluation criteria in solid tumors criteria. This process can be time consuming and have high intra- and interobserver variability. The primary aim of this serial measurements, secondary analysis study was to compare manual linear tumor response assessment to semi-automated, contoured response assessment in canine nasal tumors. The secondary objective was to determine if tumor measurements or clinical characteristics, such as stage, would correlate to progression-free interval. Three investigators evaluated paired CT scans of skulls of 22 dogs with nasal tumors obtained prior to and following radiation therapy. The automatically generated tumor volumes were not useful for canine nasal tumors in this study, characterized by poor intraobserver agreement between automatically generated contours and hand-adjusted contours. The radiologist's manual linear method of determining response evaluation criteria in solid tumors categorization and tumor volume is significantly faster (P < .0001) but significantly underestimates nasal tumor volume (P < .05) when compared to a contour-based method. Interobserver agreement was greater for volume determination using the contour-based method when compared to response evaluation criteria in solid tumors categorization utilizing the same method. However, response evaluation criteria in solid tumors categorization and percentage volume change were strongly correlated, providing validity to response evaluation criteria in solid tumors as a rapid method of tumor response assessment for canine nasal tumors. No clinical characteristics or tumor measurements were significantly associated with progression-free interval.
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Affiliation(s)
- Esther Nell
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Christopher Ober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Aaron Rendahl
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Lisa Forrest
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jessica Lawrence
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
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Mayer MN, DeWalt JO, Sidhu N, Mauldin GN, Waldner CL. Outcomes and adverse effects associated with stereotactic body radiation therapy in dogs with nasal tumors: 28 cases (2011-2016). J Am Vet Med Assoc 2020; 254:602-612. [PMID: 30779620 DOI: 10.2460/javma.254.5.602] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess outcomes, factors associated with survival time, and radiation-induced toxicoses in dogs treated for nasal tumors with curative-intent stereotactic body radiation therapy (SBRT). DESIGN Retrospective case series. ANIMALS 28 client-owned dogs. PROCEDURES By use of a 6-MV linear accelerator, dogs were treated with SBRT (3 consecutive-day fractions of 9 or 10 Gy or once with 1 fraction of 20 Gy). Data regarding adverse effects, outcomes, and survival times were obtained from the medical records. RESULTS The median survival time to death due to any cause was 388 days. Of the 24 dogs known to be dead, 14 (58%) died or were euthanized because of local disease progression. Acute radiation-induced adverse effects developed in the skin (excluding alopecia) in 26% (6/23) of dogs and in the oral cavity in 30% (7/23) of dogs. Acute ocular adverse effects included discharge in 26% (6/23) of dogs and keratoconjunctivitis sicca in 4% (1/23) of dogs. Among the 22 dogs alive at > 6 months after SBRT, 4 (18%) developed a unilateral cataract; 4 (18%) developed other complications that may have been late-onset radiation toxicoses (excluding leukotrichia and skin hyperpigmentation). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs treated with SBRT had outcomes comparable to those reported for dogs with nasal carcinomas and sarcomas that undergo conventionally fractionated radiation therapy. Administration of SBRT was associated with a comparatively lower frequency of acute radiation-induced adverse effects. For SBRT and conventionally fractionated radiation therapy, the frequencies of serious late-onset adverse effects appear similar.
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9
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Wolf F, Meier VS, Pot SA, Rohrer Bley C. Ocular and periocular radiation toxicity in dogs treated for sinonasal tumors: A critical review. Vet Ophthalmol 2020; 23:596-610. [PMID: 32281234 PMCID: PMC7496316 DOI: 10.1111/vop.12761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/26/2020] [Accepted: 03/16/2020] [Indexed: 12/25/2022]
Abstract
Visual impairment from radiation‐induced damage can be painful, disabling, and reduces the patient's quality of life. Ocular tissue damage can result from the proximity of ocular organs at risk to irradiated sinonasal target volumes. As toxicity depends on the radiation dose delivered to a certain volume, dose‐volume constraints for organs at risk should ideally be known during treatment planning in order to reduce toxicity. Herein, we summarize published ocular toxicity data of dogs irradiated for sinonasal tumors from 36 publications (1976‐2018). In particular, we tried to extract a dose guideline for a clinically acceptable rate of ocular toxicity. The side effects to ocular and periocular tissues were reported in 26/36 studies (72%) and graded according to scoring systems (10/26; 39%). With most scoring systems, however, toxicities of different ocular and periocular tissues are summed into one score. Further, the scores were mostly applied in retrospect and lack volume‐ and dose‐data. This incomplete information reflects the crux of the matter for radiation dose tolerance in canine ocular tissues: The published information of the last three decades does not allow formulating dose‐volume guidelines. As a start, we can only state that a mean dose of 39 Gy (given in 10 x 4.2 Gy fractions) will lead to loss of vision by one or both eyes, while mean doses of <30 Gy seem to preserve functionality. With a future goal to define tolerated doses and volumes of ocular and periocular tissues at risk, we propose the use of combined ocular toxicity scoring systems.
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Affiliation(s)
- Friederike Wolf
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Valeria S Meier
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Department of Physics, University of Zurich, Zurich, Switzerland
| | - Simon A Pot
- Ophthalmology Section, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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10
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Galloway A, Lana S, Thamm D, Boss K. Outcome and Metastatic Behavior of Canine Sinonasal Osteosarcoma (2005-2015). J Am Anim Hosp Assoc 2020; 56:98-105. [PMID: 31961217 DOI: 10.5326/jaaha-ms-6972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sinonasal neoplasms in dogs behave locally aggressively, and metastatic disease has not been a common cause of death. The metastatic rate of sinonasal osteosarcoma (OSA) is not well characterized, and reported outcomes of these patients are variable. The purpose of this study is to evaluate the outcome and metastatic behavior of canine sinonasal OSA. Medical records of canine patients diagnosed with sinonasal OSA via histopathology between January 2005 and December 2015 were reviewed. Patients with any form of treatment or no treatment were included. Time to local progression, time to metastasis, and overall survival data were evaluated. Variables that may impact outcome, such as tumor stage and treatment type, were evaluated. Twenty-seven dogs were identified that fit the inclusion criteria. Overall, 30.0% of dogs developed metastasis over the disease course, with a median time to metastasis of 458 days (95% confidence interval [CI] 318-758 days). The median time to local progression was 335 days (95% CI 264-544 days). The overall median survival time was 410 days (95% CI 341-627 days). Regarding metastasis, sinonasal OSA behaves similarly to sinonasal neoplasms of other histologies and dissimilarly to appendicular OSA. The outcome of treated patients appears similar to that of sinonasal tumor patients with other histologies.
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Affiliation(s)
- Annie Galloway
- From the Department of Clinical Sciences (A.G., S.L., D.T.) and Department of Environmental and Radiological Health Sciences (K.B.), College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Susan Lana
- From the Department of Clinical Sciences (A.G., S.L., D.T.) and Department of Environmental and Radiological Health Sciences (K.B.), College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Doug Thamm
- From the Department of Clinical Sciences (A.G., S.L., D.T.) and Department of Environmental and Radiological Health Sciences (K.B.), College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Keara Boss
- From the Department of Clinical Sciences (A.G., S.L., D.T.) and Department of Environmental and Radiological Health Sciences (K.B.), College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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11
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Jania R, Boudreaux B, Langohr I, Looper J, Rademacher N. Computed tomography imaging characteristics of canine nasal chondrosarcoma. J Small Anim Pract 2019; 60:678-682. [PMID: 31456225 DOI: 10.1111/jsap.13064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 06/19/2019] [Accepted: 07/01/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To describe the CT appearance of canine nasal chondrosarcoma and compare calcification patterns with those described in humans. MATERIALS AND METHODS CT examinations of dogs with biopsy-confirmed nasal chondrosarcoma were retrospectively reviewed and evaluated, including description of calcification patterns. RESULTS Major findings are consistent with the previously described CT appearance of canine nasal tumours. Additionally, calcification patterns described as features of human nasal chondrosarcomas were also identified. CLINICAL SIGNIFICANCE Findings may help prioritise differential lists of destructive nasal masses seen on CT in dogs.
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Affiliation(s)
- R Jania
- Department of Veterinary Clinical Sciences, Louisiana State University, School of Veterinary Medicine, Baton Rouge, Louisiana, 70803, USA
| | - B Boudreaux
- Department of Veterinary Clinical Sciences, Louisiana State University, School of Veterinary Medicine, Baton Rouge, Louisiana, 70803, USA
| | - I Langohr
- Department of Pathobiological Sciences, Louisiana State University, School of Veterinary Medicine, Baton Rouge, Louisiana, 70803, USA
| | - J Looper
- Department of Veterinary Clinical Sciences, Louisiana State University, School of Veterinary Medicine, Baton Rouge, Louisiana, 70803, USA
| | - N Rademacher
- Department of Veterinary Clinical Sciences, Louisiana State University, School of Veterinary Medicine, Baton Rouge, Louisiana, 70803, USA
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12
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Nolan MW, Dobson JM. The future of radiotherapy in small animals - should the fractions be coarse or fine? J Small Anim Pract 2018; 59:521-530. [DOI: 10.1111/jsap.12871] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 04/24/2018] [Accepted: 05/21/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. W. Nolan
- Department of Clinical Sciences; North Carolina State University; Raleigh North Carolina 27607 USA
| | - J. M. Dobson
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 0ES UK
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13
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Soukup A, Meier V, Pot S, Voelter K, Rohrer Bley C. A prospective pilot study on early toxicity from a simultaneously integrated boost technique for canine sinonasal tumours using image-guided intensity-modulated radiation therapy. Vet Comp Oncol 2018; 16:441-449. [PMID: 29761663 DOI: 10.1111/vco.12399] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/07/2018] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Abstract
In order to overcome the common local treatment failure of canine sinonasal tumours, integrated boost techniques were tried in the cobalt/orthovoltage era, but dismissed because of unacceptable early (acute) toxicity. Intriguingly, a recent calculation study of a simultaneously integrated boost (SIB) technique for sinonasal irradiation using intensity-modulated radiation therapy (IMRT) predicted theoretical feasibility. In this prospective pilot study we applied a commonly used protocol of 10 × 4.2 Gy to the planning target volume (PTV) with a 20%-SIB dose to the gross tumour volume (GTV). Our hypothesis expected this dose escalation to be clinically tolerable if applied with image-guided IMRT. We included 9 dogs diagnosed with sinonasal tumours without local/distant metastases. For treatment planning, organs at risk were contoured according to strict anatomical guidelines. Planning volume extensions (GTV/CTV/PTV) were standardized to minimize interplanner variability. Treatments were applied with rigid patient positioning and verified daily with image guidance. After radiation therapy, we set focus on early ophthalmologic complications as well as mucosal and cutaneous toxicity. Early toxicity was evaluated at week 1, 2, 3, 8 and 12 after radiotherapy. Only mild ophthalmologic complications were found. Three patients (33%) had self-limiting moderate to severe early toxicity (grade 3 mucositis) which was managed medically. No patient developed ulcerations/haemorrhage/necrosis of skin/mucosa. The SIB protocol applied with image-guided IMRT to treat canine sinonasal tumours led to clinically acceptable side effects. The suspected increased tumour control probability and the risk of late toxicity with the used dose escalation of 20% has to be further investigated.
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Affiliation(s)
- A Soukup
- Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - V Meier
- Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - S Pot
- Division of Ophthalmology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - K Voelter
- Division of Ophthalmology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - C Rohrer Bley
- Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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14
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de Toledo GN, Reina Moreira PR, Rolemberg DS, Facin AC, Hough Monteiro JE, Menezes MPD, Bastos Andrade Moutinho da Conceição ME, Ruiz Sueiro FA, Oliveira Vasconcelos RD, Castro Moraes PD, Costa MT, de Nardi AB. Intranasal Osteosarcoma in a Dog-A Case Report. Top Companion Anim Med 2018; 33:35-39. [PMID: 30236408 DOI: 10.1053/j.tcam.2018.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 11/11/2022]
Abstract
Osteosarcoma is the most commonly reported bone tumor in dogs, typically affecting the axial and appendicular skeleton. Involvement of the paranasal sinuses and the nasal cavity is extremely rare. This report describes a 6-year-old, female, cross-breed dog presented with signs of 90 days duration and diagnosed with a mass located in the right nasal cavity. Radiography, rhinoscopy, and computed tomography findings suggested the presence of an intranasal tumor. Osteosarcoma in the nasal cavity was diagnosed based on histopathological examination and clinical and imaging findings. Survival time was 12 months from diagnosis.
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Affiliation(s)
- Gabriela Noronha de Toledo
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil.
| | - Pamela Rodrigues Reina Moreira
- Department of Veterinary Pathology, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP /FCAV), Jaboticabal, SP, Brazil
| | - Daniele Santos Rolemberg
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
| | - Andréia Coutinho Facin
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
| | - Julio Edward Hough Monteiro
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
| | - Mareliza Possa de Menezes
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
| | | | | | - Rosemeri de Oliveira Vasconcelos
- Department of Veterinary Pathology, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP /FCAV), Jaboticabal, SP, Brazil
| | - Paola de Castro Moraes
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
| | - Mirela Tinucci Costa
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
| | - Andrigo Barboza de Nardi
- Department of Clinic and Veterinary Surgery, School of Agrarian and Veterinary Sciences, São Paulo State University (UNESP/FCAV), Jaboticabal, SP, Brazil
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15
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Abstract
The nasal cavity and sinuses may be exposed primarily via a dorsal or ventral surgical approach. Surgical planning involves the use of advanced imaging, such as computed tomography or MRI. Surgical treatment of lesions of the nasal cavity usually is limited to benign lesions or can also be used in combination with adjunctive therapy, such as radiation therapy. Extreme caution must be exercised with a dorsal approach to the nasal cavity to avoid complications of inadvertent penetration into the brain case. Gentle tissue handling and careful closure of the mucoperiosteum must be exercised following a ventral approach to minimize the risk of oronasal fistula formation.
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16
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Skinner OT, Boston SE, Souza CHDM. Patterns of lymph node metastasis identified following bilateral mandibular and medial retropharyngeal lymphadenectomy in 31 dogs with malignancies of the head. Vet Comp Oncol 2016; 15:881-889. [DOI: 10.1111/vco.12229] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/23/2016] [Accepted: 03/06/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Owen T. Skinner
- Small Animal Hospital; University of Florida; Gainesville FL USA
| | - Sarah E. Boston
- Small Animal Hospital; University of Florida; Gainesville FL USA
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17
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George R, Smith A, Schleis S, Brawner W, Almond G, Kent M, Wypij J, Borrego J, Moore A, Keyerleber M, Kraiza S. OUTCOME OF DOGS WITH INTRANASAL LYMPHOMA TREATED WITH VARIOUS RADIATION AND CHEMOTHERAPY PROTOCOLS: 24 CASES. Vet Radiol Ultrasound 2016; 57:306-12. [PMID: 26763938 DOI: 10.1111/vru.12318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 09/10/2015] [Accepted: 10/27/2015] [Indexed: 11/29/2022] Open
Abstract
Tumors of the nasal cavity comprise approximately 1% of all neoplasms in dogs. Canine intranasal lymphoma is rare and reports evaluating the outcome of treatment are lacking. The goal of this observational, descriptive, multi-institutional study was to evaluate the overall median survival times (MSTs) in a group of dogs with intranasal lymphoma that were treated with irradiation and/or chemotherapy. Dogs meeting these inclusion criteria were retrospectively recruited from medical archives at multiple institutions. Eighteen cases of intermediate to high grade intranasal lymphoma and six cases of low-grade intranasal lymphoma were identified. The date of diagnosis, method of diagnosis, treatment received (radiation and/or chemotherapy protocols), and date of death were recorded. Kaplan-Meier survival analysis was performed on the intermediate to high grade group to calculate overall MST. Log-rank tests were performed to compare effects of treatment with radiation therapy ± chemotherapy and chemotherapy alone. Kaplan-Meier survival analysis was performed separately on the low-grade group. The overall MST was 375 days for the intermediate to high grade group. Cases treated with radiation ± chemotherapy had an MST of 455 days (n = 12) and those treated with chemotherapy alone (n = 6) had an MST of 157 days in the intermediate to high grade group. The MST was 823 days for the low-grade group. Results support the use of radiation therapy for treatment of canine intranasal lymphoma, however a randomized, controlled, clinical trial would be needed for more definitive recommendations. The role of adjunctive chemotherapy also may require further investigation.
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Affiliation(s)
- Rebecca George
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, 36849
| | - Annette Smith
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, 36849
| | - Stephanie Schleis
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, 36849
| | - William Brawner
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, 36849
| | - Gregory Almond
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, 36849
| | - Michael Kent
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, Davis, CA, 95616
| | - Jackie Wypij
- Department of Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana-Champaign, IL, 61802
| | - Juan Borrego
- Instituto Veterinario de Oncología Comparada (IVOC), Valencia, España, and University of Wisconsin-Madison School of Veterinary Medicine, Madison, WI, 53706
| | - Antony Moore
- Veterinary Oncology Consultants, Wauchope, New South Wales, Australia, 2446
| | - Michele Keyerleber
- Department of Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536 and Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, 14853
| | - Sarah Kraiza
- Florida Veterinary Referral Center, Estero, FL, 33928
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18
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Selmic LE, Lafferty MH, Kamstock DA, Garner A, Ehrhart NP, Worley DR, Withrow SJ, Lana SE. Outcome and prognostic factors for osteosarcoma of the maxilla, mandible, or calvarium in dogs: 183 cases (1986–2012). J Am Vet Med Assoc 2014; 245:930-8. [DOI: 10.2460/javma.245.8.930] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Nakata M, Miwa Y, Tsuboi M, Uchida K. Surgical and localized radiation therapy for an intranasal adenocarcinoma in a rabbit. J Vet Med Sci 2014; 76:1659-62. [PMID: 25649953 PMCID: PMC4300386 DOI: 10.1292/jvms.14-0008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An 8-year-old spayed female Netherland Dwarf rabbit presented with a two-month history of dyspnea and snoring. A computed tomography (CT) scan of the head revealed mass lesions in the right nasal cavity. Surgical exenteration of the lesions was performed, and the histopathological diagnosis was an intranasal adenocarcinoma. On the basis of this diagnosis, radiotherapy was planned and consisted of eight fractions of 6 Gy administered once a week. After the completion of radiation therapy, the soft tissue density in the right nasal cavity, as detected by CT, significantly decreased. The prognosis has remained good for over 3 years after treatment. This paper is the first to describe the clinical and pathological features of an intranasal tumor in a rabbit.
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Affiliation(s)
- Makoto Nakata
- Miwa Exotic Animal Hospital, 1-25-5 Komagome, Toshima-ku, 170-0003 Tokyo, Japan
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20
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Bowles K, DeSandre-Robinson D, Kubicek L, Lurie D, Milner R, Boston SE. Outcome of definitive fractionated radiation followed by exenteration of the nasal cavity in dogs with sinonasal neoplasia: 16 cases. Vet Comp Oncol 2014; 14:350-360. [PMID: 25178539 DOI: 10.1111/vco.12115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/13/2014] [Accepted: 07/23/2014] [Indexed: 11/28/2022]
Abstract
Local control is a major challenge in treating canine nasal tumours. Surgical cytoreduction prior to radiation therapy has not been shown to offer a survival advantage. Only one study has previously evaluated the outcome when surgery is performed after radiation, which demonstrated an improved survival time compared with radiation alone. The purpose of this study was to investigate the outcome of surgery after definitive radiation on survival times in dogs with sinonasal tumours. Medical records were retrospectively reviewed for dogs with nasal tumours that received definitive radiation followed by surgery. Information obtained from medical record review included signalment, diagnosis, treatment and outcome. The median survival time was 457 days. No long-term side effects were observed. These findings suggest that exenteration of the nasal cavity following definitive radiation for treatment of dogs with nasal tumours is well-tolerated and provides a similar survival duration to previous reports of radiation alone.
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Affiliation(s)
- K Bowles
- Department of Clinical Sciences, University of Florida, Gainesville, FL, USA
| | - D DeSandre-Robinson
- Department of Oncology, Affiliated Veterinary Specialists, Maitland, FL, USA
| | - L Kubicek
- Department of Clinical Sciences, University of Florida, Gainesville, FL, USA
| | - D Lurie
- Department of Oncology, Affiliated Veterinary Specialists, Maitland, FL, USA
| | - R Milner
- Department of Clinical Sciences, University of Florida, Gainesville, FL, USA
| | - S E Boston
- Department of Clinical Sciences, University of Florida, Gainesville, FL, USA
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