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Martin TW, Griffin L. Prospective pilot study utilizing changes in quantitative values obtained on serial fluorine-18 fluorodeoxyglucose ( 18F-FDG) positron emission tomography-computed tomography (PET/CT) in dogs with appendicular osteosarcoma before and after stereotactic body radiation therapy (SBRT) and carboplatin chemotherapy to assess for prediction of survival and therapeutic effectiveness. Vet Radiol Ultrasound 2024; 65:408-416. [PMID: 38655687 DOI: 10.1111/vru.13361] [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: 11/30/2023] [Revised: 01/24/2024] [Accepted: 03/10/2024] [Indexed: 04/26/2024] Open
Abstract
Serial fluorine 18 fluorodeoxyglucose (18F-FDG) positron emission tomography-CT (PET/CT) is commonly used in human oncology to prognosticate and evaluate for therapeutic effectiveness. In this pilot study, dogs with naturally occurring appendicular osteosarcoma were evaluated with serial 18F-FDG PET/CT in an attempt to assess for response to therapy, prognostic factors, and appropriateness of imaging intervals. Fourteen dogs were enrolled in the trial. All dogs had the initial 18F-FDG PET/CT (PET1), with nine dogs having their end-of-therapy 18F-FDG PET/CT (EoT PET) 3 months after stereotactic body radiation therapy (SBRT) to the primary tumor. The median percent change from the PET1 to the EoT PET for the standard uptake value maximum (SUVmax%) was -58% (range: -17 to -88%), metabolic tumor volume (MTV%) was -99.8% (range: -65 to -100%), and total lesion glycolysis (TLG%) was -99.8% (range: -75 to -100%), all of which were significant (P < .05, <.05, and <.05, respectively). On evaluation, it was found that volumes of GTV and CTV were significant for survival (P < .05 and <.05), MTV1, TLG1, and SUVmax on the EoT PET (SUVmaxEoT) were predictive of metastasis (P < .05), and the SUVmax% was significantly correlated to the time to first event (P < .05). Based on this data, serial 18F-FDG PET/CT performed 3 months after SBRT can show a significant reduction in avidity, and the quantitative data collected may help predict metastatic disease in canine appendicular osteosarcoma.
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Affiliation(s)
- Tiffany W Martin
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Lynn Griffin
- VCA Canada Central Victoria Veterinary Hospital, Victoria, British Columbia, Canada
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Nolan MW, Gieger TL. Update in Veterinary Radiation Oncology: Focus on Stereotactic Radiation Therapy. Vet Clin North Am Small Anim Pract 2024; 54:559-575. [PMID: 38160099 DOI: 10.1016/j.cvsm.2023.12.009] [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] [Indexed: 01/03/2024]
Abstract
Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are needed, and a unique biological mechanism distinguishes SRT from other forms of external beam radiotherapy. Families find the convenient schedules and minimal acute toxicity of SRT appealing. Common indications in veterinary oncology include nasal, brain, and bone tumors. Many other solid tumors can also be treated, including spinal, oral, lung, heart-base, liver, adrenal, and prostatic malignancies. Accessibility of SRT is improving, and new data are constantly emerging to define parameters for appropriate case selection, radiation dose prescription, and long-term follow-up.
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Affiliation(s)
- Michael W Nolan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA.
| | - Tracy L Gieger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA
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Séguin B, Liptak JM. Updates in Surgical Oncology. Vet Clin North Am Small Anim Pract 2024; 54:577-589. [PMID: 38238221 DOI: 10.1016/j.cvsm.2023.12.010] [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] [Indexed: 03/25/2024]
Abstract
New knowledge and data can influence the treatment options of dogs and cats affected by neoplasms. Partial limb amputation with the use of a prosthesis is possible in dogs. Newer studies attempt to define better and understand the complications and limb function associated with this approach. Limb sparing is an alternative to amputation, and three-dimensional printing allows the manufacturing of personalized endoprostheses. Finally, the recommended approach for the excision of cutaneous mast cell tumors (MCTs) is with proportional margins. In dogs, grade shifting might have occurred when removing a recurrent MCT or soft tissue sarcoma.
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Affiliation(s)
- Bernard Séguin
- Central Victoria Veterinary Hospital, 760 Roderick Street, Victoria, British Columbia V8X 2R3, Canada.
| | - Julius M Liptak
- Capital City Specialty & Emergency Animal Hospital, 747 Silver Seven Road, Kanata, Ontario K2V 0A2, Canada
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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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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: 3] [Impact Index Per Article: 1.5] [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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6
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Le Bras LA, Timercan A, Llido M, Petit Y, Seguin B, Lussier B, Brailovski V. Personalized endoprostheses for the proximal humerus and scapulohumeral joint in dogs: Biomechanical study of the muscles’ contributions during locomotion. PLoS One 2022; 17:e0262863. [PMID: 35073361 PMCID: PMC8786195 DOI: 10.1371/journal.pone.0262863] [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: 08/16/2021] [Accepted: 01/06/2022] [Indexed: 11/21/2022] Open
Abstract
Osteosarcoma represents one of the most common bone tumours in dogs. It commonly occurs in the proximal humerus, the most affected anatomic site. Until recently, amputation or limb-sparing surgery leading to an arthrodesis coupled with chemotherapy were the only available treatments, but they often lead to complications, reduced mobility and highly impact dog’s quality of life. Prototypes of both articulated and monobloc (no mobility) patient-specific endoprostheses have been designed to spare the limb afflicted with osteosarcoma of the proximal humerus. This study focuses on the biomechanical effects of endoprostheses and shoulder muscle kinematics. For each of the endoprosthesis designs, a minimal number of muscles needed to ensure stability and a certain degree of joint movement during walking is sought. A quasi-static study based on an optimization method, the minimization of the sum of maximal muscle stresses, was carried out to assess the contribution of each muscle to the shoulder function. The identification of the most important muscles and their impact on the kinematics of the prosthetic joint lead to an improvement of the endoprosthesis design relevance and implantation feasibility.
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Affiliation(s)
- Linh-Aurore Le Bras
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
| | - Anatolie Timercan
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
| | - Marie Llido
- Faculté de Médecine Vétérinaire, Département de Sciences Cliniques, Université de Montréal, Montréal, Québec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
| | - Bernard Seguin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, United States of America
| | - Bertrand Lussier
- Faculté de Médecine Vétérinaire, Département de Sciences Cliniques, Université de Montréal, Montréal, Québec, Canada
| | - Vladimir Brailovski
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
- * E-mail:
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Martin TW, LaRue SM, Griffin L. CT characteristics and proposed scoring scheme are predictive of pathologic fracture in dogs with appendicular osteosarcoma treated with stereotactic body radiation therapy. Vet Radiol Ultrasound 2021; 63:82-90. [PMID: 34672060 DOI: 10.1111/vru.13033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/21/2021] [Accepted: 08/21/2021] [Indexed: 11/28/2022] Open
Abstract
Stereotactic body radiation therapy (SBRT) is an established limb-sparing treatment for dogs with appendicular osteosarcoma (OSA) and pathologic fractures are a common sequela. The objectives of this retrospective, observational, and descriptive study were to develop and evaluate objective CT criteria for predicting pathologic fractures and assess impacts on survival time. Included dogs had confirmed or suspected appendicular OSA, available CT scans, available outcome data, and were treated with SBRT. For each study, the number of quartiles affected by lysis on the most severely affected transverse slice, longest measurable length of contiguous full cortical lysis, presence of subchondral bone lysis, and ratio of the length of the affected bone to normal bone were recorded. A scoring system was developed for assigning grades (summed score 1-4 = grade 1, 5-7 = grade 2, and 8 or greater = grade 3.) A total of 127 CT datasets were sampled (123 patients). The median summed score was 7. The grade was correlated with pathologic fracture development (23% of grade 1, 35% of grade 2, and 57% of grade 3 resulting in fracture, P = 0.028). Subchondral bone lysis was correlated with fracture (odds ratio, 2.2, P = 0.02). Percent affected bone ≥40% was associated with decreased survival (P = 0.002). Dogs with <40% of affected bone had a median survival of 256 days versus 178 days for dogs with ≥40% affected bone. Findings from the current study can be used to assist in determining prognosis and planning radiation therapy for future dogs affected by appendicular OSA.
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Affiliation(s)
- Tiffany Wormhoudt Martin
- Department of Environmental Health and Radiological Sciences, Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
| | - Susan M LaRue
- Department of Environmental Health and Radiological Sciences, Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
| | - Lynn Griffin
- Department of Environmental Health and Radiological Sciences, Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
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Martin TW, Griffin L, Custis J, Ryan SD, Lafferty M, Boss MK, Regan D, Rao S, Leary D, Withrow SJ, LaRue SM. Outcome and prognosis for canine appendicular osteosarcoma treated with stereotactic body radiation therapy in 123 dogs. Vet Comp Oncol 2021; 19:284-294. [PMID: 33403752 DOI: 10.1111/vco.12674] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022]
Abstract
Canine appendicular osteosarcoma is commonly treated with limb amputation; however, limb-sparing options are frequently desired or necessary for a subset of patients. We evaluated 123 patients and 130 sites treated with stereotactic body radiation therapy (SBRT). Eighty-two out of 98 dogs (84%) had maximum lameness improvement at a median of 3 weeks for a median of 6 months duration. Histopathologic evaluation of available samples from amputation or necropsy revealed >80% tumor necrosis in 50% of limbs consistent with local disease control. Of evaluable patients, 41% fractured and 21% pursued an amputation after treatment. Fine needle aspirate (n = 52) and needle core biopsy (n = 28) did not result in increased fracture risk compared to those without tumor sampling (n = 50). Median survival time (MST) was 233 days and time to first event was 143 days. Gross tumor volume and planned target volume were significantly inversely associated with survival and tumor location was significantly associated with survival. Dogs with salvage amputation had a significantly longer MST compared to those without (346 vs 202 days; P = .04). The presence of metastatic disease at the time of treatment in 15 dogs did not significantly impact survival time (200 vs 237 days without metastasis; P = .58). Skin side effects correlated significantly with dose with 33% of patients with acute grade 3 effects developing consequential late grade 3 effects. While SBRT improves lameness in most patients, further investigation is needed to identify candidates with minimal early fracture risk prior to initiating therapy.
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Affiliation(s)
- Tiffany Wormhoudt Martin
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Lynn Griffin
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - James Custis
- Department of Radiation Oncology, VCA Animal Diagnostic Clinic, Dallas, Texas, USA
| | - Stewart D Ryan
- Veterinary Clinical Sciences, The University of Melbourne, Victoria, Australia
| | - Mary Lafferty
- Department of Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Mary-Keara Boss
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Daniel Regan
- Department of Microbiology, Immunology, and Pathology College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Sangeeta Rao
- Department of Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Del Leary
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Stephen J Withrow
- Department of Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Susan M LaRue
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Pentreath RJ, Applegate KE, Higley KA, Peremans K, Natsuhori M, Randall E, Gambino J. Radiological protection of the patient in veterinary medicine and the role of ICRP. Ann ICRP 2020; 49:169-181. [PMID: 32885662 DOI: 10.1177/0146645320946619] [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] [Indexed: 01/18/2023]
Abstract
At the request of the Main Commission of the International Commission on Radiological Protection (ICRP), Task Group 107 (TG107) was set up to consider the issue of radiological protection of the patient in veterinary medicine. TG107, who authored this article, brought together information relating to the use of diagnostic imaging and radiation oncology in veterinary medicine. A number of specific areas were identified that appeared to be appropriate for attention by ICRP. These included the use of dose quantities and units, the need for re-evaluation of stochastic and deterministic risks from ionising radiation in animals, and the growing use of imaging and therapeutic equipment for animals that is little different from that available to humans. TG107 unanimously recommended that it was both appropriate and timely for ICRP to consider and advise on these issues, and the Main Commission agreed. This paper summarises the findings of TG107.
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Affiliation(s)
- R J Pentreath
- Emeritus Member ICRP Main Commission, Honorary Research Fellow, Plymouth Marine Laboratory, Prospect Place, The Hoe, Plymouth, PL1 3DH, UK; e-mail:
| | | | | | | | - M Natsuhori
- Kitasato University School of Veterinary Medicine, Japan
| | | | - J Gambino
- American College of Veterinary Radiology, USA
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Kalamaras AB, Wavreille V, Jones SC, Litsky AS, Selmic L. Impact of microwave ablation treatment on the biomechanical properties of the distal radius in the dog: A cadaveric study. Vet Surg 2020; 49:1388-1395. [PMID: 32706150 DOI: 10.1111/vsu.13481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/20/2020] [Accepted: 06/01/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether microwave ablation (MWA) modifies the biomechanical properties of the normal distal radius in the dog to better estimate the clinical impact of MWA as a tool for the treatment of neoplastic bone lesions. STUDY DESIGN Biomechanical experimental study. SAMPLE POPULATION Sixteen pairs of dog forelimbs from 16 canine cadavers. METHODS From each pair of forelimbs, one radius was randomly assigned to an MWA group, and the other radius was randomly assigned to a control group. Bone tunnels were created in each distal radial epiphysis for a length of 6 cm toward the middiaphysis. In the MWA group, the ablation probe was inserted into the bone tunnel for a series of three ablation treatments. Specimens were then tested in three-point bending to acute failure with the middle point located 3 cm from the distal articular surface (middle of the ablated zone). Load and displacement were continuously recorded to determine maximum displacement and peak load before failure. Data were analyzed with noninferiority tests. RESULTS The mean peak loads for the control group and MWA group were 1641.9 N and 1590.9 N, respectively. Microwave ablation-treated radii were not biomechanically inferior to control radii (P < .0001). CONCLUSION Microwave ablation of normal cadaveric dog distal radii did not affect the maximum displacement and peak load before failure. CLINICAL SIGNIFICANCE Microwave ablation does not affect biomechanical bending properties of the distal radius in the dog. Future studies, both cadaveric and in vivo, are required to evaluate the impact of MWA on neoplastic bone.
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Affiliation(s)
- Alexandra B Kalamaras
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio
| | - Vincent Wavreille
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio
| | - Stephen C Jones
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio
| | - Alan S Litsky
- Department of Biomedical Engineering, The Ohio State University College of Engineering, Columbus, Ohio
| | - Laura Selmic
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio
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11
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Salyer SA, Wavreille VA, Fenger JM, Jennings RN, Selmic LE. Evaluation of microwave ablation for local treatment of dogs with distal radial osteosarcoma: A pilot study. Vet Surg 2020; 49:1396-1405. [PMID: 32697356 DOI: 10.1111/vsu.13491] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the feasibility and safety of microwave ablation (MWA) as a modality to induce tumor necrosis within distal radial osteosarcoma (OSA). STUDY DESIGN Pilot study. ANIMALS Six client-owned dogs with distal radius OSA confirmed by cytological examination. METHODS Dogs underwent computed tomography for surgical planning before general anesthesia for fluoroscopy-guided ablation. Computed tomography was repeated 48 hours after MWA, before amputation. The ablated tumor was evaluated with histopathology. RESULTS Six dogs underwent MWA of distal radius OSA. A lower power setting (30 W) was selected for the first two dogs to avoid collateral soft tissue damage. The power was increased to 75 W for the last four dogs. The temperature was maintained between 45°C and 55°C (113 °F-131 °F) at the bone/soft tissue interface. Tumor necrosis varied between 30% and 90% (median, 55%) according to histopathology. No intraoperative or periprocedural complications were observed. CONCLUSION Microwave ablation induced variable tumor necrosis and did not induce immediate postablation complications in these six dogs with distal radius OSA. CLINICAL SIGNIFICANCE These results justify further evaluation of MWA as a potential modality to treat primary bone lesions in dogs.
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Affiliation(s)
- Sarah A Salyer
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Vincent A Wavreille
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Joelle M Fenger
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Ryan N Jennings
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Laura E Selmic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
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12
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Lee J, Moon H, Ku B, Lee K, Hwang CY, Baek SJ. Anticancer Effects of Cold Atmospheric Plasma in Canine Osteosarcoma Cells. Int J Mol Sci 2020; 21:E4556. [PMID: 32604902 PMCID: PMC7349329 DOI: 10.3390/ijms21124556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/13/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
Abstract
Osteosarcoma is known to be one of the frequently occurring cancers in dogs. Its prognosis is usually very poor, with a high incidence of lung metastasis. Although radiation therapy has become a major therapeutic choice for canine osteosarcoma, the high costs and unexpected side effects prevent some patients from considering this treatment. Cold atmospheric plasma (CAP) is an ionized gas with high energy at low temperatures, and it produces reactive oxygen species that mediate many signaling pathways. Although many researchers have used CAP as an anticancer therapeutic approach in humans, its importance has been neglected in veterinary medicine. In this study, D-17 and DSN canine osteosarcoma cell lines were treated with CAP to observe its anticancer activity. By high-content screening and flow cytometry, CAP-treated cells showed growth arrest and apoptosis induction. Moreover, the osteosarcoma cells exhibited reduced migration and invasion activity when treated with CAP. Overall, CAP exerted an anticancer effect on canine osteosarcoma cell lines. CAP may have the potential to be used as a novel modality for treating cancer in veterinary medicine.
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Affiliation(s)
- Jaehak Lee
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea; (J.L.); (H.M.); (C.-Y.H.)
| | - Hyunjin Moon
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea; (J.L.); (H.M.); (C.-Y.H.)
| | - Bonghye Ku
- R&D Center, PSM Inc. Jungwon-gu, Seongnam-si, Gyeonggi-do 13207, Korea; (B.K.); (K.L.)
| | - Keunho Lee
- R&D Center, PSM Inc. Jungwon-gu, Seongnam-si, Gyeonggi-do 13207, Korea; (B.K.); (K.L.)
| | - Cheol-Yong Hwang
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea; (J.L.); (H.M.); (C.-Y.H.)
| | - Seung Joon Baek
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea; (J.L.); (H.M.); (C.-Y.H.)
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13
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Nolan MW, Green NA, DiVito EM, Lascelles BDX, Haney SM. Impact of radiation dose and pre-treatment pain levels on survival in dogs undergoing radiotherapy with or without chemotherapy for presumed extremity osteosarcoma. Vet Comp Oncol 2020; 18:538-547. [PMID: 32048435 DOI: 10.1111/vco.12576] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 01/19/2023]
Abstract
The purpose of this bi-institutional retrospective study was to determine whether survival for dogs with extremity osteosarcoma (OS) is improved through the use of stereotactic radiotherapy (SRT; a single fraction of 25 Gy, or 36 Gy total given in three consecutive daily fractions) plus chemotherapy, vs lower dose conventionally planned and delivered hypofractionated radiotherapy (CHRT; 14-20 Gy total in 1-2 consecutive daily fractions) plus chemotherapy. We also sought to determine whether baseline pain severity influences oncologic outcomes following radiotherapy for canine extremity OS. The medical records of 82 dogs undergoing radiotherapy for confirmed or presumed OS were reviewed. In dogs receiving combinations of both chemotherapy and radiotherapy, survival was significantly longer with SRT vs CHRT (median overall survival time: 350 vs 147 days; P = .031). In a univariate analysis, dogs with pulmonary metastases and high pain at the time of irradiation had short overall survival times; use of high radiation doses and chemotherapy were associated with improved survival. Separate multivariable models were built to assess the predictive nature of various factors that might influence event-free or overall survival in dogs treated with radiotherapy, with or without chemotherapy; for dogs treated with both chemotherapy and radiotherapy, overall survival times were significantly longer when baseline pain scores were 'low' (vs 'high'; hazard ratio: 0.258; P = .030), radiation doses were high (hazard ratio: 0.943; P = .034). Neither pain nor radiation dose were associated with survival in dogs treated with radiotherapy, without chemotherapy.
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Affiliation(s)
- Michael W Nolan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.,Duke Cancer Institute, Duke University, Durham, North Carolina
| | - Noah A Green
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Elizabeth M DiVito
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - B Duncan X Lascelles
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.,Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Thurston Arthritis Center, UNC School of Medicine, Chapel Hill, North Carolina.,Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, North Carolina
| | - Siobhan M Haney
- Veterinary CyberKnife Cancer Center, Malvern, Pennsylvania.,Hope Veterinary Specialists, Malvern, Pennsylvania
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14
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Magestro LM, Cahoon JY, Gieger TL, Nolan MW. Radiotherapy isocenters verified by matching to bony landmarks of the canine and feline head differ when localized using volumetric versus planar imaging. Vet Comp Oncol 2019; 17:562-569. [PMID: 31322802 DOI: 10.1111/vco.12522] [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: 04/03/2019] [Revised: 07/05/2019] [Accepted: 07/06/2019] [Indexed: 01/08/2023]
Abstract
The "gold standard" for verification of patient positioning before linear accelerator-based stereotactic radiation therapy is kilovoltage cone-beam computed tomography (kV-CBCT), which is not uniformly available or utilized; planar imaging is sometimes used instead. The primary aim of this study was to determine if the position of the bony skull, when used as a surrogate for isocenter verification, is different when orthogonal megavoltage (MV) portal or kilovoltage (kV/kV) radiographs are used for image guidance, rather than kV-CBCT. A secondary aim was to determine the influence of intra-observer variability, body size and skull conformation on positioning, as determined using these three imaging modalities. Dogs and cats receiving radiotherapy of the head were recruited for this prospective analytical study. Planar (MV portal and kV/kV images) and volumetric (kV-CBCT) images were acquired before treatment, and manually coregistered with reference images. Differences in skull position when matched based on MV portal, kV/kV images and kV-CBCT were compared. A total of 65 subjects and 148 unique datasets were evaluated. The Wilcoxon rank-sum test was used to evaluate effects of transitioning between imaging modalities. When comparing magnitude of shifts in MV to kV-CBCT, MV to kV/kV and kV/kV to kV-CBCT, there were statistically significant differences. Results were not measurably impacted by body size, skull conformation or interobserver differences. Based on shift magnitude and direction, an isotropic setup margin of at least 1 mm should be incorporated within the planning target volume when MV or kV planar imaging is used for position verification.
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Affiliation(s)
- Leanne M Magestro
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Joyce Y Cahoon
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Tracy L Gieger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Michael W Nolan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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15
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Séguin B, Pinard C, Lussier B, Williams D, Griffin L, Podell B, Mejia S, Timercan A, Petit Y, Brailovski V. Limb-sparing in dogs using patient-specific, three-dimensional-printed endoprosthesis for distal radial osteosarcoma: A pilot study. Vet Comp Oncol 2019; 18:92-104. [PMID: 31209977 DOI: 10.1111/vco.12515] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/26/2019] [Accepted: 05/31/2019] [Indexed: 12/22/2022]
Abstract
Limb-sparing for distal radial osteosarcoma has a high rate of complications. Using personalized three-dimensional (3D)-printed implants might improve outcome. The goals of this study were to optimize use of patient-specific, 3D-printed endoprostheses for limb-sparing in dogs in the clinical environment and to report the outcome. This was a pilot study where five client-owned dogs were enrolled. Computed tomography (CT) of the thoracic limbs was performed, which was used to create patient-specific endoprostheses and cutting guides, and repeated on the day of surgery. Intra-arterial (IA) carboplatin was introduced in the clinical management. Limb-sparing was performed. Outcome measures were time required to produce the endoprosthesis and cutting guide, fit between cutting guide and endoprosthesis with host bones, gait analysis, size of the tumour, percent tumour necrosis, complications, disease-free interval (DFI) and survival time (ST). Four dogs received IA carboplatin. Excessive tumour growth between planning CT and surgery did not occur in any dog. The interval between the CT and surgery ranged from 14 to 70 days. Fit between the cutting-guide and endoprosthesis with the host bones was good to excellent. At least one complication occurred in all dogs. Two dogs were euthanized with STs of 192 and 531 days. The other dogs were alive with a follow up of 534 to 575 days. IA chemotherapy is a promising strategy to minimize the risk of excessive tumour growth while waiting for the endoprosthesis and cutting-guide to be made. The design of the cutting-guide was critical for best fit of the endoprosthesis with host bones.
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Affiliation(s)
- Bernard Séguin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Chris Pinard
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Bertrand Lussier
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Montréal, Québec, Canada
| | - Deanna Williams
- Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Lynn Griffin
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Brendan Podell
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Sebastian Mejia
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Anatolie Timercan
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
| | - Vladimir Brailovski
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
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16
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Griffin LR, Thamm DH, Brody A, Selmic LE. Prognostic value of fluorine 18 flourodeoxyglucose positron emission tomography/computed tomography in dogs with appendicular osteosarcoma. J Vet Intern Med 2019; 33:820-826. [PMID: 30768736 PMCID: PMC6430893 DOI: 10.1111/jvim.15453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/30/2019] [Indexed: 12/22/2022] Open
Abstract
Background Factors indicative of a negative prognosis for appendicular osteosarcoma (OSA) in dogs are visible metastatic disease, location, and size of lesion. In human medicine maximum standard uptake value (SUVmax), as measured on a fluorine18 flourodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT), is prognostic for survival for several tumor types. Objective Determine if SUVmax is associated with progression‐free interval (PFI) and determination of survival in dogs with appendicular OSA. Animals Sixty‐two dogs with untreated appendicular OSA that had been staged with 18F‐FDG PET/CT. Methods Retrospective analysis of the 18F‐FDG PET/CT was performed. Dogs were excluded from the study if they did not receive definitive intent treatment for their primary OSA and adjuvant chemotherapy with carboplatin, or had visible metastatic disease on initial imaging. A region of interest (ROI) was created around the primary tumor to measure SUVmax. Univariable and multivariable Cox proportional hazards analysis was performed to evaluate for associations between variables including SUVmax and outcome of PFI and overall survival (OS). Results Maximum standard uptake value of the primary tumor was significantly associated with the OS (P = .04) with adjustment for treatment type and monocyte count. The overall median survival time (OST) was 284 days (range, 39‐1293 days) with the OST of dogs having an SUVmax of ≥7.4 of 254 days (range, 98‐428 days) and dogs with an SUVmax of <7.4 of 680 days (range, 108‐811 days, P = .01). Conclusions and Clinical Importance Maximum standard uptake value as measured via 18F‐FDG PET/CT is significantly associated with survival in dogs with appendicular OSA with a high SUVmax being an indicator of a negative prognosis.
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Affiliation(s)
- Lynn R Griffin
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Douglas H Thamm
- Department of Clinical Sciences and Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Ariel Brody
- North Carolina State University Veterinary Hospital, Raleigh, North Carolina
| | - Laura E Selmic
- Ohio State University Veterinary Medical Center, Columbus, Ohio
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17
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Fan TM, Selting KA. Exploring the Potential Utility of Pet Dogs With Cancer for Studying Radiation-Induced Immunogenic Cell Death Strategies. Front Oncol 2019; 8:680. [PMID: 30697532 PMCID: PMC6340932 DOI: 10.3389/fonc.2018.00680] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/27/2018] [Indexed: 01/21/2023] Open
Abstract
Radiotherapy serves as a foundational pillar for the therapeutic management of diverse solid tumors through the generation of lethal DNA damage and induction of cell death. While the direct cytotoxic effects of radiation therapy remain a cornerstone for cancer management, in the era of immunooncology there is renewed and focused interest in exploiting the indirect bystander activities of radiation, termed abscopal effects. In radioimmunobiologic terms, abscopal effects describe the radiotherapy-induced regression of cancerous lesions distant from the primary site of radiation delivery and rely upon the induction of immunogenic cell death and consequent systemic anticancer immune activation. Despite the promise of radiation therapy for awaking potent anticancer immune responses, the purposeful harnessing of abscopal effects with radiotherapy remain clinically elusive. In part, failure to fully leverage and clinically implement the promise of radiation-induced abscopal effects stems from limitations associated with existing conventional tumor models which inadequately recapitulate the complexity of malignant transformation and the dynamic nature of tumor immune surveillance. To supplement this existing gap in modeling systems, pet dogs diagnosed with solid tumors including melanoma and osteosarcoma, which are both metastatic and immunogenic in nature, could potentially serve as unique resources for exploring the fundamental underpinnings required for maximizing radiation-induced abscopal effects. Given the spontaneous course of cancer development in the context of operative immune mechanisms, pet dogs treated with radiotherapy for metastatic solid tumors might be leveraged as valuable model systems for realizing the science and best clinical practices necessary to generate potent abscopal effects with anti-metastatic immune activities.
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Affiliation(s)
- Timothy M Fan
- Comparative Oncology Research Laboratory, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign Urbana, IL, United States
| | - Kimberly A Selting
- Comparative Oncology Research Laboratory, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign Urbana, IL, United States
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18
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Séguin B, Walsh PJ, Ehrhart EJ, Hayden E, Lafferty MH, Selmic LE. Lateral manus translation for limb-sparing surgery in 18 dogs with distal radial osteosarcoma in dogs. Vet Surg 2018; 48:247-256. [DOI: 10.1111/vsu.13132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/10/2018] [Accepted: 05/14/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Bernard Séguin
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | | | - E. J. Ehrhart
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | - Eva Hayden
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Mary H. Lafferty
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | - Laura E. Selmic
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine; University of Illinois Urbana-Champaign; Urbana Illinois
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19
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Dunfield EM, Turek MM, Buhr KA, Christensen NI. A survey of stereotactic radiation therapy in veterinary medicine. Vet Radiol Ultrasound 2018; 59:786-795. [PMID: 30062728 DOI: 10.1111/vru.12671] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/14/2018] [Accepted: 05/22/2018] [Indexed: 12/31/2022] Open
Abstract
Radiotherapy plays an important role in curative and palliative cancer treatment. As a novel radiation delivery technique, stereotactic radiotherapy utilizes three-dimensional-conformal treatment planning, high-precision beam delivery technology, and patient specific position verification to target tumors, often in one to five high-dose fractions. Currently, there is no consensus about best stereotactic radiotherapy practices in veterinary radiotherapy. The objective of this study was to document the breadth of perspectives, techniques, and applications of stereotactic radiotherapy in veterinary medicine. We conducted an online survey of American College of Veterinary Radiology members specializing in radiation oncology to assess how, when, and why stereotactic radiotherapy is being used. Both stereotactic radiotherapy users and nonusers completed the survey. The overall response and survey completion rates were 54% (67/123) and 87% (58/67), respectively. Overall, 55% of respondents reported providing stereotactic radiotherapy at their facility, with a median of 4.5 canine cases and one feline case per month. Delivery methods included C-arm linear accelerator with multi-leaf collimator, helical tomotherapy, and CyberKnife. Nonpituitary intracranial tumors, pituitary tumors, and sinonasal tumors were the most common cancers treated using stereotactic radiotherapy in both species. The most common fractionation scheme was three fractions of 10 Gy/fraction. The results of this survey suggest common availability of stereotactic radiotherapy in veterinary radiation facilities. These results provide valuable information regarding current stereotactic radiotherapy practices in veterinary medicine, and may provide an initial step toward standardizing methods and establishing consensus guidelines.
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Affiliation(s)
- Elizabeth M Dunfield
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706
| | - Michelle M Turek
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706
| | - Kevin A Buhr
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53706
| | - Neil I Christensen
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706
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20
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Wustefeld-Janssens BG, Lafferty M, Séguin B. Modification of the metal endoprosthesis limb-salvage procedure for excision of a large distal radial osteosarcoma in a dog: A case report. Vet Surg 2018; 47:802-808. [PMID: 30051470 DOI: 10.1111/vsu.12924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/07/2017] [Accepted: 01/09/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To report modification of the endoprosthesis surgical limb-salvage technique to treat a locally extensive osteosarcoma in a dog and associated functional outcome. STUDY DESIGN Clinical case report. ANIMALS One client-owned dog. METHODS A 9-year-old dog was presented for treatment of a locally extensive distal radial osteosarcoma. A limb-salvage surgery was performed with a second-generation Veterinary Orthopedic Implants (VOI) endoprosthesis to reconstruct the radial segmental and carpal osseous defect. The endoprosthesis was stabilized with a 16-mm-wide locking VOI limb-salvage plate. The level of the osteotomy of the radius/ulna was 3 cm proximal to the periosteal reaction seen on radiographs, and the distal osteotomy extended through the proximal metacarpal bones (II-V), 3 cm from the distal extent of the soft tissue component of the tumor. A 3.5-mm SOP (String of Pearls) plate was used as adjunct fixation. RESULTS The postoperative functional outcome was classified as acceptable. Ambulation was normal, with mild subjective lameness on the treated limb at examinations 20, 43, and 63 days after surgery. The dog was euthanized 92 days after surgery because of progressive metastatic disease. CONCLUSION The modified endoprosthetic technique allowed complete excision of the carpal joint, which resulted in acceptable functional outcomes in the dog described here. CLINICAL SIGNIFICANCE Distal ostectomies may include part of the manus during limb salvage surgery of locally extensive distal radial osteosarcoma and using an endoprosthesis implant to reconstruct the defect.
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Affiliation(s)
- Brandan G Wustefeld-Janssens
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.,Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Mary Lafferty
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Bernard Séguin
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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21
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Association between computed tomographic characteristics and fractures following stereotactic radiosurgery in dogs with appendicular osteosarcoma. Vet Radiol Ultrasound 2018; 59:499. [DOI: 10.1111/vru.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Kent MS, Turek MM, Farrelly J. Recent advances in veterinary radiation oncology. Vet Comp Oncol 2018; 16:167-169. [PMID: 29333737 DOI: 10.1111/vco.12366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 12/28/2022]
Affiliation(s)
- M S Kent
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California
| | - M M Turek
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - J Farrelly
- Blue Pearl Veterinary Partners, New York, New York
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23
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Kent MS, Turek MM, Farrelly J. Recent advances in veterinary radiation oncology. Vet Radiol Ultrasound 2018; 59:10-12. [DOI: 10.1111/vru.12573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Michael S. Kent
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California; Davis USA
| | - Michelle M. Turek
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison USA
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24
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Swift KE, LaRue SM. Outcome of 9 dogs treated with stereotactic radiation therapy for primary or metastatic vertebral osteosarcoma. Vet Comp Oncol 2017; 16:E152-E158. [DOI: 10.1111/vco.12362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/21/2017] [Accepted: 09/22/2017] [Indexed: 01/07/2023]
Affiliation(s)
- K. E. Swift
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins Colorado
| | - S. M. LaRue
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins Colorado
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25
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Bray JP, Kersley A, Downing W, Crosse KR, Worth AJ, House AK, Yates G, Coomer AR, Brown IWM. Clinical outcomes of patient-specific porous titanium endoprostheses in dogs with tumors of the mandible, radius, or tibia: 12 cases (2013–2016). J Am Vet Med Assoc 2017; 251:566-579. [DOI: 10.2460/javma.251.5.566] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Séguin B, O'Donnell MD, Walsh PJ, Selmic LE. Long-term outcome of dogs treated with ulnar rollover transposition for limb-sparing of distal radial osteosarcoma: 27 limbs in 26 dogs. Vet Surg 2017; 46:1017-1024. [PMID: 28792618 DOI: 10.1111/vsu.12698] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 03/27/2017] [Accepted: 04/04/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To determine outcomes in dogs with distal radial osteosarcoma treated with ulnar rollover transposition (URT) limb-sparing surgery including: viability of the ulnar graft, complications, subjective limb function, disease-free interval (DFI), and survival time (ST). STUDY DESIGN Retrospective case series. ANIMALS Twenty-six client-owned dogs with distal radial osteosarcoma and no involvement of the ulna. METHODS Data of dogs treated with URT were collected at the time of surgery and retrospectively from medical records and by contacting owners and referring veterinarians. RESULTS URT technique was performed on 27 limbs in 26 dogs. The ulnar graft was determined to be viable in 17 limbs, nonviable in 3, and unknown in 7. Complications occurred in 20 limbs. Infection was diagnosed in 12 limbs. Biomechanical complications occurred in 15 and local recurrence in 2 limbs. Limb function graded by veterinarians or owners was poor in 2 limbs, fair in 4, good in 14, excellent in 3, and unknown in 4. Median DFI was 245 days and median ST was 277 days. CONCLUSION The URT technique maintained the viability of the ulnar graft. The complication rate was high but limb function appeared acceptable. Although sufficient length of the distal aspect of the ulna must be preserved to perform this technique, local recurrence was not increased compared to other limb-sparing techniques when cases were appropriately selected.
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Affiliation(s)
- Bernard Séguin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California.,Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Matthew D O'Donnell
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Peter J Walsh
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California.,Veterinary Specialty Group, West Sacramento, California
| | - Laura E Selmic
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
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27
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Boston SE, Vinayak A, Lu X, Larue S, Bacon NJ, Bleedorn JA, Souza CHM, Ehrhart NP. Outcome and complications in dogs with appendicular primary bone tumors treated with stereotactic radiotherapy and concurrent surgical stabilization. Vet Surg 2017; 46:829-837. [PMID: 28477425 DOI: 10.1111/vsu.12669] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To document the outcome of dogs with appendicular primary bone tumors treated with stereotactic radiotherapy (SRT) and concurrent stabilization. STUDY DESIGN Multi-institutional retrospective case series. ANIMALS Eighteen dogs with presumptive or definitive diagnosis of appendicular osteosarcoma. METHODS Medical records of dogs with appendicular primary bone tumors treated with SRT and stabilization were reviewed for signalment, preoperative staging and diagnostics, radiation dose, stabilization method, and outcome. RESULTS The distal radius was affected in 13/18 cases. Osteosarcoma or sarcoma was confirmed cytologically or histologically in 15/18 cases. Seven dogs were diagnosed with a pathological fracture at the time of treatment, and 11 were considered at high risk for pathological fracture. Dogs received a single dose (n = 5) or 3 doses (n = 13) of SRT. Surgical stabilization was performed under the same anesthetic event as the final dose of SRT in 10 dogs. Stabilization was achieved with a bone plate (n = 15) or interlocking nail (n = 3). Seventeen dogs received adjuvant chemotherapy. Complications occurred in 16/17 dogs, 15/17 of those being considered major complications. Four dogs experienced more than one complication. Infection was the most common complication, diagnosed in 15/17 cases, and considered as a major complication in 13/15 cases. Postoperative fracture was recorded as a major complication in 3 cases. Nine dogs were amputated at a median of 152 days. The median survival time was 344 days. CONCLUSION Treatment of bone tumors with SRT and concurrent stabilization was associated with a prohibitively high complication rate in dogs. Alternative methods for limb salvage should be considered for dogs at risk for pathologic fracture.
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Affiliation(s)
- Sarah E Boston
- Small Animal Clinical Sciences, University of Florida, Gainesville, Florida
| | - Arathi Vinayak
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Xiaomin Lu
- Department of Biostatistics & Children's Oncology Group, University of Florida, Gainesville, Florida
| | - Susan Larue
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | | | - Jason A Bleedorn
- Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin
| | - Carlos H M Souza
- Small Animal Clinical Sciences, University of Florida, Gainesville, Florida
| | - Nicole P Ehrhart
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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28
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Garcia TC, Steffey MA, Zwingenberger AL, Daniel L, Stover SM. CT-derived indices of canine osteosarcoma-affected antebrachial strength. Vet Surg 2017; 46:549-558. [DOI: 10.1111/vsu.12645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/10/2016] [Accepted: 12/06/2016] [Indexed: 01/23/2023]
Affiliation(s)
- Tanya C. Garcia
- Department of Anatomy, Physiology and Cell Biology Surgical, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Michele A. Steffey
- Department of Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Allison L. Zwingenberger
- Department of Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Leticia Daniel
- Department of Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Susan M. Stover
- Department of Anatomy, Physiology and Cell Biology Surgical, School of Veterinary Medicine; University of California-Davis; Davis California
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