Nasal Flashcards
What is the MST of dogs with nasal carcinoma who receive no treatment?
95 days
T/F: epistaxis is a negative prognostic indicator for dogs with nasal tumors?
True
What is the MST of dogs with nasal tumors with and without epistaxis?
Epistaxis: MST 88 days
No epistaxis: MST 224 days
How does the MST of dogs with nasal tumors treated with surgery compare to that of dogs who are untreated?
Not substantially improved (3-6 months with surgery; 95 days if no treatment)
What is the MST for dogs with nasal tumors treated with computer-planned RT?
11 to 19.7 months
Describe the modified Adams staging system for nasal tumors.
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
What are the most common late ocular effects in dogs treated with nasal radiation, and in what time frame do they typically occur?
KCS, cataracts, and blindness
6-9 months post-RT
In what % of dogs with nasal tumors does marked tumor regression occur after definitive RT?
46%
CT-verified
“Marked regression” defined as 90% reduction
What was the outcome for dogs with nasal tumors who received full-course RT followed by surgical removal of residual disease?
Better than with RT alone (MST 47 months) but increased late effects: rhinitis, osteomyelitis, fistula
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.
False - too toxic; RT-related deaths in 1/3 of dogs.
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.
False: significant hematologic toxicity and local acute tissue reactions
Compare IMRT to traditional computer-planned RT with respect to ocular toxicity and MST.
MST for both groups were similar; IMRT resulted in bilateral ocular sparing compared to non-IMRT protocols.
What is a potential drawback to using IMRT protocols for treating nasal tumors?
Even small (mm) variations in patient set-up can result in tumor underdose or normal tissue overdose. Typically requires rigid immobilization techniques.
For dogs with nasal tumors, what % experience improvement in clinical signs when treated with palliative RT protocols? What is the median duration of control?
66-100%
146-300 days (4.8 months - 9.7 months)
What two factors have been associated with longer survival in dogs with nasal tumors receiving palliative RT?
Stage I disease
Clinical signs >90 days
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.
927 days
What % of dogs receiving re-irradiation for nasal tumor developed late side effects?
100%
Mild in 7/9
Severe in 2/9 (resulted in euthanasia)
What is the ORR to single-agent cisplatin for dogs with nasal tumors?
27%
All dogs experienced alleviation of clinical signs
What is the ORR to doxo/carbo/piroxicam therapy for dogs with nasal tumors?
75%
All dogs experienced alleviation of clinical signs
Give 7 negative prognostic factors for dogs with nasal tumors.
- Age > 10 years
- Epistaxis
- Duration of clinical signs
- Advanced stage
- Metastatic disease
- Histo subtype (SCC or undifferentiated)
- Failure of treatment to control signs
What is the DFS and OS for dogs with modified Adams stage IV nasal tumors?
DFS: 3.8 months
OS: ~7 months
In cats with nasal tumors, what % are malignant?
> 90%
T/F: adenocarcinoma is the most common nasal tumor in cats.
False - lymphoma
Describe the typical cell size and immunophenotype of nasal lymphoma in cats.
Large cell (91%), B cell (68%)
