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Yoshikawa H, Gieger TL, Saba CF, Fredrickson K, Kubicek L, Haney S, Ruslander D, Kelsey KL, McEntee MC, Nolan MW. Retrospective evaluation of intranasal carcinomas in cats treated with external-beam radiotherapy: 42 cases. J Vet Intern Med 2021; 35:1018-1030. [PMID: 33660305 PMCID: PMC7995428 DOI: 10.1111/jvim.16098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/07/2022] Open
Abstract
Background Little is known regarding the comparative efficacy of various irradiation strategies used to treat intranasal carcinomas (INC) in cats. Objectives Investigate outcomes and prognostic factors associated with survival for cats with INC. Animals Forty‐two cats with INC that underwent radiotherapy (RT). Methods Single‐arm retrospective study. Medical record review for cats with INC that underwent RT at 1 of 7 veterinary RT facilities. Irradiation protocols categorized as: definitive‐intent fractionated RT (FRT), definitive‐intent stereotactic RT (SRT), and palliative‐intent RT (PRT). Median overall survival time (OST) and disease progression‐free survival (PFS; documented by advanced transverse imaging, or recurrence of symptoms) were calculated. Associations between tumor stage, RT protocol/intent, and adjunctive treatment usage and outcome were calculated. Results Cats underwent SRT (N = 18), FRT (N = 8), and PRT (N = 16). In multivariate modeling, cats received definitive‐intent treatment (DRT; FRT/SRT) had significantly longer median PFS (504 days, [95% confidence interval (CI): 428–580 days] vs PRT 198 days [95% CI: 62–334 days]; p = 0.006) and median OST [721 days (95% CI: 527–915 days) vs 284 days (95% CI: 0–570 days); p = 0.001]). Cats that underwent second DRT course at time of recurrence lived significantly longer than cats that received 1 RT course (either DRT or PRT [median OST 824 days (95% CI: 237–1410 days) vs 434 days (95% CI: 277–591 days); p = .028]). Conclusion In cats with INC, DRT is associated with prolonged OST and PFS as compared to PRT. If tumor progression occurs, a second course of DRT should be considered.
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Affiliation(s)
- Hiroto Yoshikawa
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Tracy L Gieger
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Corey F Saba
- College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Kirsha Fredrickson
- College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | | | - Siobhan Haney
- Hope Veterinary Specialists, Malvern, Pennsylvania, USA
| | - David Ruslander
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Krista L Kelsey
- Carolina Veterinary Specialists, Matthews, North Carolina, USA
| | | | - Michael W Nolan
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
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2
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Stiborova K, Meier VS, Takada M, Turek M, Poirier VJ, Laliberte S, Rohrer Bley C. Definitive-intent radiotherapy for sinonasal carcinoma in cats: A multicenter retrospective assessment. Vet Comp Oncol 2020; 18:626-633. [PMID: 32134553 DOI: 10.1111/vco.12583] [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: 09/30/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 11/27/2022]
Abstract
Treatment of epithelial sinonasal tumours in cats is not commonly reported. In the newer reports, palliative radiation protocols have been described more often than definitive-intent protocols. In this multi-institutional retrospective study, we included 27 cats treated with single-modality radiotherapy. Cats were irradiated using 10 daily fractions of 4.2 Gy. Three cats (11.1%) experienced a complete clinical response and 17 (63%) had a partial clinical response. Stable clinical disease was noted in three cats (11.1%). Four cats (14.8%) showed progression within 3 months following treatment. The median time to progression for all cases was 269 days (95 % confidence intervals [CI]: 225; 314). The proportion of cats free of progression at 1 and 2 years was 24% (95% CI: 22%; 26%) and 5% (95% CI: 5%; 6%), respectively. None of the prognostic factors evaluated were predictive of outcome (anaemia, tumour volume at the time of staging, modified Adams stage, intracranial involvement, facial deformity, epistaxis, inappetence or weight loss). Median overall survival (OS) for all deaths was 452 days (95% CI: 334; 571). The proportion of cats alive at 1 and 2 years was 57% (95% CI: 37%; 77%) and 27% (95% CI: 25%; 29%), respectively. Surprisingly, cats with epistaxis had a longer median OS of 828 days (95% CI: 356; 1301) compared to 296 days (95% CI: 85; 508) in cats without epistaxis, (P = .04, Breslow). Radiation therapy used as a single modality for the treatment of feline sinonasal carcinoma improved clinical signs and was well tolerated but progression within a year was common.
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Affiliation(s)
- Katerina Stiborova
- Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Valeria S Meier
- Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Department of Physics, University of Zurich, Zurich, Switzerland
| | - Marilia Takada
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michelle Turek
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Valerie J Poirier
- Animal Cancer Centre, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Sarah Laliberte
- Animal Cancer Centre, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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3
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Marchesi MC, Valli L, Angeli G, Savastano V, Caivano D. Functional endoscopic sinus surgery in a cat with nasal tumor. J Vet Med Sci 2019; 81:1219-1222. [PMID: 31270284 PMCID: PMC6715927 DOI: 10.1292/jvms.19-0213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
An 11-year-old, 5.8-kg, male European cat was presented with a 4-month history of
sneezing, nasal discharge, respiratory distress and bilateral conjunctivitis. Physical
examination showed bilateral hemorrhagic mucopurulent nasal discharge and stertorous
respiratory sounds. An irregular shaped mass involving the aboral portion of the right
nasal cavity and sphenoidal sinus was identified by computed tomography. The mass was
localized endoscopically in the medium meatus and an endoscopic-guided biopsy was
performed. B-cell lymphoma was diagnosed by histopathological and immunochemistry exams.
Functional endoscopic sinus surgery allowed to completely remove the tumor and restore a
normal nasal flow. The cat showed no recurrence of the neoplasia for 15 months after the
functional endoscopic sinus surgery.
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Affiliation(s)
- Maria Chiara Marchesi
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126, Italy
| | - Laura Valli
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126, Italy
| | - Giovanni Angeli
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126, Italy
| | - Vincenzo Savastano
- Department of Pediatrics, Policlinico Umberto I, Viale Regina Elena 324, Rome, 00161, Italy
| | - Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126, Italy
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4
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Hansen KS, Kent MS. Imaging in Non-neurologic Oncologic Treatment Planning of the Head and Neck. Front Vet Sci 2019; 6:90. [PMID: 30984771 PMCID: PMC6448413 DOI: 10.3389/fvets.2019.00090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 03/06/2019] [Indexed: 12/26/2022] Open
Abstract
Imaging is critical for the diagnosis and staging of veterinary oncology patients. Although cytology or biopsy is generally required for diagnosis, imaging characteristics inform the likelihood of a cancer diagnosis, can result in a prioritized list of differentials that guide further staging tests, and assist in the planning of surgery, radiation, and chemotherapy options. Advanced imaging, such as CT and MRI, can better define the extent of disease for surgical and radiation planning for head and neck cancer cases in particular. Additionally, new imaging technologies are continually being translated into veterinary fields, and they may provide more options for cancer patients as they become more widely available.
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Affiliation(s)
- Katherine S Hansen
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, Davis, CA, United States
| | - Michael S Kent
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, Davis, CA, United States
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5
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Interventional Radiology Management of Nonresectable Neoplasia. Vet Clin North Am Small Anim Pract 2018; 48:891-898. [DOI: 10.1016/j.cvsm.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Thrift E, Greenwell C, Turner AL, Harvey AM, Maher D, Malik R. Metastatic pulmonary carcinomas in cats ('feline lung-digit syndrome'): further variations on a theme. JFMS Open Rep 2017; 3:2055116917691069. [PMID: 28491449 PMCID: PMC5359792 DOI: 10.1177/2055116917691069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
CASE SERIES SUMMARY The aim of this retrospective case series was to describe seven cases where cats with primary lung tumours were presented because of metastases to extra-pulmonary sites ('feline lung-digit syndrome'). Specifically, we wanted to emphasise less typical case descriptions where tumour emboli resulted in lesions developing in the musculature (including the muscles of the head), skin or distal aorta. RELEVANCE AND NOVEL INFORMATION The cases are presented to increase clinical awareness of this entity in feline practice, especially when characteristic combinations of clinical signs are present. When clinicians have a high index of suspicion for these presentations, radiology (thorax and digits) or ultrasound (distal aorta), combined with collection of fine needle aspirate specimens for cytology, are usually sufficient to secure a definitive diagnosis. Novel information in this series includes CT and MRI findings from some cases. Typically, needle aspiration or biopsy targeting the skin, digits and lesions in musculature is far easier compared with sampling the primary tumour site in the lungs. The differential diagnosis and investigation of multiple digital lesions is also considered.
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Affiliation(s)
- Elizabeth Thrift
- Animal Referral Hospital, 250 Parramatta Road, Homebush West, NSW, Australia
| | - Chris Greenwell
- Small Animal Specialist Hospital, 1 Richardson Place, North Ryde, NSW, Australia
| | | | - Andrea M Harvey
- Small Animal Specialist Hospital, 1 Richardson Place, North Ryde, NSW, Australia
| | - Donna Maher
- Gungahlin Veterinary Hospital, 21 Crinigan Circle, Gungahlin, ACT, Australia
| | - Richard Malik
- Centre of Veterinary Education, B22, The University of Sydney, NSW, Australia
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7
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Weisse C. Veterinary interventional oncology: From concept to clinic. Vet J 2015; 205:198-203. [DOI: 10.1016/j.tvjl.2015.03.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/22/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
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8
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Dickinson P. Advances in diagnostic and treatment modalities for intracranial tumors. J Vet Intern Med 2014; 28:1165-85. [PMID: 24814688 PMCID: PMC4857954 DOI: 10.1111/jvim.12370] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 02/24/2014] [Accepted: 03/25/2014] [Indexed: 12/23/2022] Open
Abstract
Intracranial neoplasia is a common clinical condition in domestic companion animals, particularly in dogs. Application of advances in standard diagnostic and therapeutic modalities together with a broad interest in the development of novel translational therapeutic strategies in dogs has resulted in clinically relevant improvements in outcome for many canine patients. This review highlights the status of current diagnostic and therapeutic approaches to intracranial neoplasia and areas of novel treatment currently in development.
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Affiliation(s)
- P.J. Dickinson
- Department of Surgical and Radiological SciencesSchool of Veterinary MedicineUniversity of California DavisDavisCA
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9
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Reed N, Gunn-Moore D. Nasopharyngeal disease in cats: 2. Specific conditions and their management. J Feline Med Surg 2012; 14:317-26. [PMID: 22511474 PMCID: PMC11132258 DOI: 10.1177/1098612x12444998] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PRACTICAL RELEVANCE Nasopharyngeal disease is a common presenting problem in feline medicine. CLINICAL CHALLENGES The management of feline nasopharyngeal disease can be challenging at a number of levels. In many cases, a specific diagnosis may remain elusive. Some conditions may not be curable so owners need to understand the requirement for long-term management. In addition, treatment may be compromised by poor patient compliance. AUDIENCE This review, which is directed at any clinicians involved in the management of cats with nasopharyngeal disease, discusses acute rhinitis (cat 'flu) and a variety of conditions causing chronic rhinosinusitis/chronic nasopharyngeal disease. The intention is to assist treatment decision making by reviewing the most appropriate therapies from the options available for these patients. EVIDENCE BASE The information presented in this article is based on peer-reviewed publications and the clinical experience of the authors.
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Affiliation(s)
- Nicki Reed
- Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Sciences, University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland, UK.
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Abstract
PRACTICAL RELEVANCE While the most common cause of chronic upper respiratory disease signs in cats is viral disease, with subsequent, self-perpetuating inflammation, other, more discrete causes need to be ruled out. These include foreign bodies, bacterial or fungal infections, oral-dental diseases and neoplasia. Any factors contributing to alterations in the structure or function of the upper airways, including inflammation of any cause, will compromise normal function and predispose to chronic damage if the cat is unable to resolve the underlying factors. CLINICAL CHALLENGES The chronic feline snuffler is a frustrating patient to treat. The longer the course of disease, the more severe the consequences to affected tissues, and the more debilitated the patient becomes. A logical diagnostic plan to differentiate probable etiologies and to rule out non-viral causes results in appropriate therapeutic choices. Even with a viral etiology, therapies to reduce the pathological consequences of infection may modulate and help control the clinical signs. Some novel choices and drug combinations are discussed in this review. PATIENT GROUP Cats of all ages may be affected. Cats with conformational (breed or malformation) characteristics, such as short or convoluted nasal passages or very small nostrils, are predisposed to unresolving inflammation. Fungal disease is more relevant in specific geographic regions, making inclusion of a travel history important in history collection. Older cats are more likely to have neoplasia-induced signs. AUDIENCE This review is directed at all veterinarians who see cats with chronic, recurrent upper respiratory disease.
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Affiliation(s)
- Margie Scherk
- CatsINK, 4381 Gladstone Street, Vancouver, BC, Canada V5N 4Z4.
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Bulman-Fleming JC, Turner TR, Rosenberg MP. Evaluation of adverse events in cats receiving long-term piroxicam therapy for various neoplasms. J Feline Med Surg 2010; 12:262-8. [PMID: 20363461 PMCID: PMC11135588 DOI: 10.1016/j.jfms.2009.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2009] [Indexed: 11/25/2022]
Abstract
The role of cyclo-oxygenase 2 (COX-2) and prostaglandins (PG) in carcinogenesis has been documented in many species. Piroxicam has shown efficacy against several neoplasms and is frequently prescribed for chronic use. There are no studies investigating chronic piroxicam administration in cats and the chronic use of non-steroidal anti-inflammatory agents in this species has long been cautioned against. This retrospective study aimed to evaluate adverse effects in cats receiving long-term daily piroxicam. Seventy-three cats received daily piroxicam at doses of 0.13-0.41mg/kg. Treatment duration ranged from 1 to 38 months. Treatment with piroxicam was found to significantly increase frequency of vomiting during the first month of therapy, though this was most significant for cats receiving concurrent chemotherapy. Piroxicam administration was not significantly associated with hematologic, renal or hepatic toxicities. Adverse events were not correlated with dosage. Adverse events were reported in 29% of cats, and were generally mild and transient. Eight percent discontinued piroxicam due to adverse reaction, and 4% due to difficult administration. This study indicates that long-term daily piroxicam is generally well tolerated in cats at conventional doses.
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