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Round Two > Nasal > Flashcards

Nasal Flashcards

1
Q

What is the MST of dogs with nasal carcinoma who receive no treatment?

A

95 days

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2
Q

T/F: epistaxis is a negative prognostic indicator for dogs with nasal tumors?

A

True

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3
Q

What is the MST of dogs with nasal tumors with and without epistaxis?

A

Epistaxis: MST 88 days

No epistaxis: MST 224 days

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4
Q

How does the MST of dogs with nasal tumors treated with surgery compare to that of dogs who are untreated?

A

Not substantially improved (3-6 months with surgery; 95 days if no treatment)

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5
Q

What is the MST for dogs with nasal tumors treated with computer-planned RT?

A

11 to 19.7 months

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6
Q

Describe the modified Adams staging system for nasal tumors.

A

I: confined to one nasal passage or sinus; no bone involvement other than turbinates
II: Any bone involvement beyond turbinates, but no mass in orbit, SQ, or submucosa
III: Involvement of orbit or extension into SQ, submucosa, or nasopharynx
IV: Cribiform plate lysis

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7
Q

What are the most common late ocular effects in dogs treated with nasal radiation, and in what time frame do they typically occur?

A

KCS, cataracts, and blindness

6-9 months post-RT

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8
Q

In what % of dogs with nasal tumors does marked tumor regression occur after definitive RT?

A

46%
CT-verified
“Marked regression” defined as 90% reduction

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9
Q

What was the outcome for dogs with nasal tumors who received full-course RT followed by surgical removal of residual disease?

A

Better than with RT alone (MST 47 months) but increased late effects: rhinitis, osteomyelitis, fistula

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10
Q

T/F: A recent study suggests that dogs with nasal tumors may benefit from dose-intense RT protocols that treat to a cumulative dose 57 Gy.

A

False - too toxic; RT-related deaths in 1/3 of dogs.

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11
Q

T/F: gemcitabine has shown promise as a radiosensitizer for dogs with nasal tumors due to good tolerance of the protocol and a numerical (though not statistically significant) improvement in duration of disease control.

A

False: significant hematologic toxicity and local acute tissue reactions

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12
Q

Compare IMRT to traditional computer-planned RT with respect to ocular toxicity and MST.

A

MST for both groups were similar; IMRT resulted in bilateral ocular sparing compared to non-IMRT protocols.

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13
Q

What is a potential drawback to using IMRT protocols for treating nasal tumors?

A

Even small (mm) variations in patient set-up can result in tumor underdose or normal tissue overdose. Typically requires rigid immobilization techniques.

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14
Q

For dogs with nasal tumors, what % experience improvement in clinical signs when treated with palliative RT protocols? What is the median duration of control?

A

66-100%

146-300 days (4.8 months - 9.7 months)

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15
Q

What two factors have been associated with longer survival in dogs with nasal tumors receiving palliative RT?

A

Stage I disease

Clinical signs >90 days

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16
Q

What was the MST for dogs treated with re-irradiation of their nasal tumors? 50 Gy the first time, 36 Gy the second time, ~513 days between courses.

A

927 days

17
Q

What % of dogs receiving re-irradiation for nasal tumor developed late side effects?

A

100%
Mild in 7/9
Severe in 2/9 (resulted in euthanasia)

18
Q

What is the ORR to single-agent cisplatin for dogs with nasal tumors?

A

27%

All dogs experienced alleviation of clinical signs

19
Q

What is the ORR to doxo/carbo/piroxicam therapy for dogs with nasal tumors?

A

75%

All dogs experienced alleviation of clinical signs

20
Q

Give 7 negative prognostic factors for dogs with nasal tumors.

A
  • Age > 10 years
  • Epistaxis
  • Duration of clinical signs
  • Advanced stage
  • Metastatic disease
  • Histo subtype (SCC or undifferentiated)
  • Failure of treatment to control signs
21
Q

What is the DFS and OS for dogs with modified Adams stage IV nasal tumors?

A

DFS: 3.8 months
OS: ~7 months

22
Q

In cats with nasal tumors, what % are malignant?

A

> 90%

23
Q

T/F: adenocarcinoma is the most common nasal tumor in cats.

A

False - lymphoma

24
Q

Describe the typical cell size and immunophenotype of nasal lymphoma in cats.

A

Large cell (91%), B cell (68%)

25
Q

In a study of 123 cats with nasal tumors, 21 had regional lymphadenopathy. How many of these cats had metastasis to their lymph nodes?

A

None

26
Q

What is the MST of cats with non-LSA nasal tumors who receive definitive RT?

A

12 months

Another study showed MST 13 months with a coarse-fraction protocol

27
Q

What is the ORR of feline nasal LSA treated with RT?

A

70-90%

28
Q

What % of cats with nasal LSA go on to develop LSA at non-nasal sites?

A

13-16%

29
Q

T/F: Cox-2 expression is prognostic for survival in dogs with nasal tumors.

A

False

Round Two (4 decks)

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