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Rohrer Bley C, Meier V, Turek M, Besserer J, Unterhirkhers S. Stereotactic Radiation Therapy Planning, Dose Prescription and Delivery in Veterinary Medicine: A Systematic Review on Completeness of Reporting and Proposed Reporting Items. Vet Comp Oncol 2024. [PMID: 39367729 DOI: 10.1111/vco.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/25/2024] [Accepted: 08/26/2024] [Indexed: 10/06/2024]
Abstract
Increasing numbers of dogs and cats with cancer are treated with stereotactic radiosurgery, stereotactic radiation therapy or stereotactic body radiotherapy (SRS, SRT or SBRT). We provide a systematic review of the current data landscape with a focus on technical and dosimetric data of stereotactic radiotherapy in veterinary oncology. Original peer-reviewed articles on dogs and cats with cancer treated with SRT were included. The systematic search included Medline via PubMed and EMBASE. The study was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. We assessed the manuscripts regarding outcome reporting, treatment planning, dose prescription, -delivery and -reporting as well as quality assurance. As of February 2024, there are 80 peer-reviewed publications on various disease entities on SRS, SRT and SBRT in veterinary medicine. Overall, we found often insufficient or highly variable technical data, with incomplete information to reproduce these treatments. While in some instances, technical factors may not impact clinical outcome, the variability found in protocols, outcome and toxicity assessments precludes accurate and reliable conclusions for a benefit of stereotactic radiotherapy for many of the treated diseases. In line with the extensive recommendations from human stereotactic radiotherapy practise, we propose a draft of reporting items for future stereotactic radiation treatments in veterinary medicine. SRS, SRT and SBRT have specific clinical and technological requirements that differ from those of standard radiation therapy. Therefore, a deep understanding of the methodologies, as well as the quality and precision of dose delivery, is essential for effective clinical knowledge transfer.
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Affiliation(s)
- Carla Rohrer Bley
- Clinic for Radiation Oncology & Medical Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Valeria Meier
- Clinic for Radiation Oncology & Medical Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Michelle Turek
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Juergen Besserer
- Clinic for Radiation Oncology & Medical Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Radiation Oncology, Hirslanden Clinic, Zurich, Switzerland
| | - Sergejs Unterhirkhers
- Clinic for Radiation Oncology & Medical Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Radiation Oncology, Hirslanden Clinic, Zurich, Switzerland
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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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3
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ICRP PUBLICATION 153 Approved by the Commission in September 2022. Ann ICRP 2022; 51:9-95. [PMID: 36942865 DOI: 10.1177/01466453221142702] [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: 03/23/2023]
Abstract
Veterinary use of radiation in the diagnosis, management, and treatment of disease has expanded and diversified, as have the corresponding radiological protection concerns. Radiological exposure of personnel involved in veterinary procedures and, where applicable, members of the public providing assistance (e.g. owners or handlers) has always been included within the system of radiological protection. Veterinary practice is now addressed explicitly as the modern complexities associated with this practice warrant dedicated consideration, and there is a need to clarify and strengthen the application of radiological protection principles in this area. The Commission recommends that the system of radiological protection should be applied in veterinary practice principally for the protection of humans, but with explicit attention to the protection of exposed animals. Additionally, consideration should be given to the risk of potential contamination of the environment associated with applications of nuclear medicine in veterinary practice. This publication focuses primarily on justification and optimisation in veterinary practice, and sets the scene for more detailed guidance to follow in future Recommendations. It is intended for a wide-ranging audience, including radiological protection professionals, veterinary staff, students, education and training providers, and members of the public, as an introduction to radiological protection in veterinary practice.© 2022 ICRP. Published by SAGE.
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Nolan MW, Berman AR, Watson-Skaggs ML, Quinn CN, Marcus KL, Russell K, Yoshikawa H, Olby NJ, Gieger TL. Stereotactic radiotherapy (10 Gy X 3) for canine nonlymphomatous intranasal tumors is associated with prolonged survival and minimal risk of severe radiotoxicity. J Am Vet Med Assoc 2022; 260:1496-1506. [DOI: 10.2460/javma.22.03.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To describe oncologic outcomes following administration of a uniform stereotactic radiotherapy protocol (SRT; 10 Gy X 3) for canine intranasal tumors and to identify whether any clinical or dosimetric factors were predictive of event-free or overall survival time (EFST or OST).
ANIMALS
129 dogs.
PROCEDURES
In this single-institution retrospective study, the medical records database was searched for canine nonlymphomatous intranasal tumors treated with 10 Gy X 3 SRT between August 2013 and November 2020. Findings regarding adverse effects and outcomes were analyzed overall, for dogs grouped on the basis of life stage (mature adult, senior, or end of life), and for treatment-related or tumor-related variables to identify potential predictors of outcome.
RESULTS
After SRT, most dogs clinically improved with minimal acute radiotoxicity. The median EFST was 237 days; median OST was 542 days. Receipt of other tumor-directed therapies before or after SRT was associated with improved EFST in senior dogs (hazard ratio [HR], 0.416) and improved OST in mature adult (HR, 0.241) and senior dogs (HR, 0.348). In senior dogs, administration of higher near-minimum radiation doses was associated with improved EFST (HR, 0.686) and OST (HR, 0.743). In senior dogs, chondrosarcoma was associated with shorter OST (HR, 7.232), and in dogs at end of life, having a squamous cell or transitional carcinoma was associated with worse EFST (HR, 6.462).
CLINICAL RELEVANCE
This SRT protocol results in improved quality of life and prolonged OST for dogs of all life stages. Radiation protocol optimization or use of multimodal therapy may further improve outcomes.
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Affiliation(s)
- Michael W. Nolan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
| | - Alyssa R. Berman
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Maegan L. Watson-Skaggs
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Claire N. Quinn
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Karen L. Marcus
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Katharine Russell
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Hiroto Yoshikawa
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
| | - Natasha J. Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
| | - Tracy L. Gieger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
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Gieger T, Haney S, Nolan MW. Re-irradiation of canine non-lymphomatous nasal tumors using stereotactic radiation therapy (10 Gy x 3) for both courses: assessment of outcome and toxicity in 11 dogs. Vet Comp Oncol 2022; 20:502-508. [PMID: 35023604 PMCID: PMC9305852 DOI: 10.1111/vco.12801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 12/02/2022]
Abstract
No uniformly beneficial treatments exist for dogs with non‐lymphomatous nasal tumours (NLNT) that relapse after radiotherapy (RT). Reirradiation may prolong survival and improve quality of life. In this retrospective study, we describe outcomes for 11 dogs that had CT‐confirmed locoregional progression of NLNT after an initial course of stereotactic RT (SRT#1; 10 Gy × 3) and were then re‐treated with the same type of protocol (SRT#2, also 10 Gy × 3). The median time between SRT #1 and SRT #2 was 243 days (95% CI: 78–385 days). Ten dogs (91%) had a clinical benefit after SRT#1; five dogs (45%) had clinical benefit after SRT#2. Adverse events after SRT#2 included nasocutaneous or oronasal fistula formation (N = 3 at 180, 270, and 468 days), seizures (N = 2 at 78 and 330 days), bacterial or fungal rhinitis (N = 2 at 240 and 385 days), and facial swelling (N = 1 at 90 days). All 11 dogs have died, due to disease progression, presumed radiotoxicity, or declining quality of life; in most cases, it was difficult to discern between these conditions. The median overall survival time (OST) from SRT#1 was 745 days (95% CI: 360–1132). The median overall survival time (OST) from SRT #2 was 448 days (95% CI: 112–626). For these dogs, survival was prolonged, but adverse events after SRT#2 were common (8/11; 73%). Therefore, before consenting to re‐irradiation with this protocol, pet owners should be counselled about survivorship challenges, including risk for severe toxicities, and persistence of clinical signs.
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Affiliation(s)
- Tracy Gieger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States
| | - Siobhan Haney
- Hope Veterinary Specialists and the Veterinary CyberKnife Cancer Center, Malvern, Pennsylvania, United States
| | - Michael W Nolan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States.,Duke Cancer Institute, Duke University, Durham, North Carolina, United States
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6
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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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Lee BI, Boss MK, LaRue SM, Martin T, Leary D. Comparative study of the collapsed cone convolution and Monte Carlo algorithms for radiation therapy planning of canine sinonasal tumors reveals significant dosimetric differences. Vet Radiol Ultrasound 2021; 63:91-101. [PMID: 34755417 DOI: 10.1111/vru.13039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022] Open
Abstract
Computer-based radiation therapy requires high targeting and dosimetric precision. Analytical dosimetric algorithms typically are fast and clinically viable but can have increasing errors near air-bone interfaces. These are commonly found within dogs undergoing radiation planning for sinonasal cancer. This retrospective methods comparison study is designed to compare the dosimetry of both tumor volumes and organs at risk and quantify the differences between collapsed cone convolution (CCC) and Monte Carlo (MC) algorithms. Canine sinonasal tumor plans were optimized with CCC and then recalculated by MC with identical control points and monitor units. Planning target volume (PTV)air , PTVsoft tissue , and PTVbone were created to analyze the dose discrepancy within the PTV. Thirty imaging sets of dogs were included. Monte Carlo served as the gold standard calculation for the dosimetric comparison. Collapsed cone convolution overestimated the mean dose (Dmean ) to PTV and PTVsoft tissue by 0.9% and 0.5%, respectively (both P < 0.001). Collapsed cone convolution overestimated Dmean to PTVbone by 3% (P < 0.001). Collapsed cone convolution underestimated the near-maximum dose (D2 ) to PTVair by 1.1% (P < 0.001), and underestimated conformity index and homogeneity index in PTV (both P < 0.001). Mean doses of contralateral and ipsilateral eyes were overestimated by CCC by 1.6% and 1.7%, respectively (both P < 0.001). Near-maximum doses of skin and brain were overestimated by CCC by 2.2% and 0.7%, respectively (both P < 0.001). As clinical accessibility of Monte Carlo becomes more widespread, dose constraints may need to be re-evaluated with appropriate plan evaluation and follow-up.
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Affiliation(s)
- Ber-In Lee
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Mary-Keara Boss
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Susan M LaRue
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Tiffany Martin
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Del Leary
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Chiti LE, Stefanello D, Manfredi M, Zani DD, De Zani D, Boracchi P, Giudice C, Grieco V, Di Giancamillo M, Ferrari R. To map or not to map the cN0 neck: Impact of sentinel lymph node biopsy in canine head and neck tumours. Vet Comp Oncol 2021; 19:661-670. [PMID: 33886154 DOI: 10.1111/vco.12697] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 12/24/2022]
Abstract
Tumour stage is a prognostic indicator for canine malignant head and neck tumours (MHNT). However, consensus is lacking on nodal staging in the absence of clinically apparent nodal disease (cN0 neck). This prospective observational study aims to determine the diagnostic accuracy of radiopharmaceutical and blue dye for sentinel lymph node biopsy (SLNB), to assess the correspondence between sentinel lymph node (SLN) and clinically expected regional lymph node (RLN) and the impact on staging of the procedure in dogs with MHNT and cN0 neck. Twenty-three dogs with MHNT and cN0 neck underwent tumour excision and SLNB guided by preoperative lymphoscintigraphy and intraoperative gamma-probe and blue dye. Diagnostic performances and detection rate were calculated. Correspondence between SLN and RLN, number of nodes excised, histopathological status of the SLN and complications related to the procedure were recorded. The mapping technique identified at least one SLN in 19/23 dogs, with a detection rate of 83%. The SLN did not correspond to the RLN in 52% of dogs. Multiple nodes were removed in 61% of dogs. At histopathology, eight (42%) dogs had SLN+, of which four differed from the RLN. Only minor self-limiting complications occurred in five (22%) dogs. Radiopharmaceutical and blue dye guidance is accurate (sensitivity 88.9%; specificity 100%) for SLNB in dogs with MHNT and cN0 and allowed the extirpation of unpredictable and/or multiple SLN with minimal morbidity. Incorporation of SLNB in the management of MHNT is desirable to correctly stage the cN0 neck, owing the unpredictability of the lymphatic drainage.
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Affiliation(s)
- Lavinia E Chiti
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Damiano Stefanello
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Martina Manfredi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Davide D Zani
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Donatella De Zani
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Boracchi
- Dipartimento di Scienze Cliniche e di Comunità, Laboratorio di Statistica Medica, Biometria ed Epidemiologia "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Chiara Giudice
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Valeria Grieco
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Mauro Di Giancamillo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Roberta Ferrari
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
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Poirier VJ, Koh ESY, Darko J, Fleck A, Pinard C, Vail DM. Patterns of local residual disease and local failure after intensity modulated/image guided radiation therapy for sinonasal tumors in dogs. J Vet Intern Med 2021; 35:1062-1072. [PMID: 33660342 PMCID: PMC7995431 DOI: 10.1111/jvim.16076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Most dogs with sinonasal tumors (SNT) treated with radiation therapy (RT) died because of local disease progression. HYPOTHESIS/OBJECTIVES Our hypothesis is that the majority of local failure and residual disease would occur within the radiation field. ANIMALS Twenty-two dogs with SNT treated with RT. METHODS Retrospective cohort study. INCLUSION CRITERIA dogs with SNT receiving 10 daily fractions of 4.2 Gy with intensity modulated radiation therapy (IMRT)/image guided radiation therapy (IGRT) and follow-up cone beam computed tomography (CBCT). Each CBCT was registered with the original radiation planning CT and the gross tumor volume (GTV) contoured. The GTV was classified as residual (GTVr) or a failure (GTVf). The dose statistic for each GTV was calculated with the original IMRT plan. For GTVf, failures were classified as "in-field," "marginal," or "out-field" if at least 95, 20-95, or less than 20% of the volume of failure was within 95% (D95) of the total prescription dose, respectively. RESULTS There were 52 follow-up CBCT/CTs. Overall there was a GTVr for 20 dogs and GTVf for 16 dogs. The majority of GTVr volume was within the original GTV. GTVf analysis showed that 75% (12/16) were "in-field," 19% (3/16) were "marginal" and 6% (1/16) were "out-field." CONCLUSION AND CLINICAL IMPORTANCE In-field failures are the main pattern for local recurrence, and there is evidence of radioresistant subvolumes within the GTV.
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Affiliation(s)
- Valerie J Poirier
- School of Veterinary Science, Massey University, Palmerston North, New Zealand.,Department of clinical studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Ethel S Y Koh
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Johnson Darko
- Department of Medical Physics, Grand River Regional Cancer Centre, Kitchener, Ontario, Canada
| | - Andre Fleck
- Department of Medical Physics, Grand River Regional Cancer Centre, Kitchener, Ontario, Canada
| | - Christopher Pinard
- Department of clinical studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - David M Vail
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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10
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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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11
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Dees DD, Kent MS. Efficacy of adjunctive therapy using Vizoovet in improving clinical signs of keratoconjunctivitis sicca in dogs: A pilot study. Vet Ophthalmol 2020; 23:632-639. [PMID: 32386123 DOI: 10.1111/vop.12763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the clinical safety and efficacy of adjunctive therapy using Vizoovet to ameliorate clinical signs of keratoconjunctivitis sicca (KCS) in dogs. ANIMALS STUDIED Twenty client-owned dogs. PROCEDURES Canine patients diagnosed with KCS were enrolled in this prospective study. Patients were randomly selected to receive either Vizoovet or GenTeal drops twice daily in addition to twice daily tacrolimus 0.03% solution. Data were collected from only one eye of each patient and included STT-1, IOP, TFBUT, and results of objective clinical scoring performed by pet owners. Statistical significance was set at P ≤ .05. RESULTS In all, 20 dogs (20 eyes) were enrolled in this prospective randomized study. Females (n = 12; 60%) outnumbered males (n = 8; 40%) and all dogs were spayed/neutered. Mean age of all dogs was 10.6 ± 3.79 years. In both treatment groups, the improvement in STT-1 values over the course of the study was significant (P = .002). When comparing the STT-1 improvements between groups, no significance was found (P = .78). In both groups, the improvement in TFBUT was significant (P = .0018). When comparing the TFBUT improvements between groups, no significance was found (P = .14). Squinting, rubbing, ocular discharge, and medication administration scores all significantly improved throughout the course of the study; however, they did not differ significantly between groups. Throughout the study, no adverse side effects were noted clinically or by the pet owner in either group. CONCLUSIONS AND CLINICAL RELEVANCE Adjunctive treatment with Vizoovet was as safe and effective as GenTeal drops at improving clinical signs of dry eye in dogs.
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Affiliation(s)
| | - Michael S Kent
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, Davis, California
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12
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Church ME, Veluvolu SM, Durham AC, Woolard KD. Clinical outcomes, ultrastructure and immunohistochemical features of canine high-grade olfactory neuroblastoma. Vet Comp Oncol 2019; 17:578-584. [PMID: 31177641 DOI: 10.1111/vco.12512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/27/2019] [Accepted: 05/29/2019] [Indexed: 11/30/2022]
Abstract
Olfactory neuroblastoma (ONB) is a rare intranasal neoplasm in both dogs and humans. Similar clinical presentation and overlapping histologic and immunohistochemical features of ONB with other intranasal neoplasms can make diagnosis and treatment of intranasal neoplasia challenging. Furthermore, in part because of their rarity, there is a lack of reporting on therapeutic regimen for these neoplasms. In humans, initial debulking surgery is usually followed by radiation therapy. Here we report on the histologic, immunohistochemical, and ultrastructural characteristics of canine ONB and report on the clinical progression of cases treated with radiation therapy. In all nine canine ONB examined here, neoplastic cells were arranged in a lobular manner amidst a prominent neurofibrillary matrix and had features consistent with Grade III (high grade) ONB. The neoplastic cells demonstrated positive immunohistochemical staining for TuJ-1, a Class III beta-tubulin neuronal cytoskeletal protein, and variable staining for other markers, including chromogranin, synaptophysin, AE1/AE3 and MAP2. The longest surviving case was treated with a regimen similar to that used in humans, consisting of debulking surgery followed by definitive radiation therapy. Our study found that TuJ-1 is a useful marker for ONB and that radiation therapy, even in cases of advanced disease, may result in prolonged survival.
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Affiliation(s)
- Molly E Church
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sridhar M Veluvolu
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amy C Durham
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kevin D Woolard
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California at Davis, Davis, California
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