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Onco Board Review 2 > Nasal Tumors > Flashcards

Nasal Tumors Flashcards

1
Q

What are positive prognostic factors for nasal LSA in cats? (5)

A

epitheliotropism, RT > 32 Gy, localized (stage 1), eating well, FeLV negative

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2
Q

What are negative prognostic factors for nasal LSA in cats? (4)

A

age, anemia, anorexia, cribriform involvement

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3
Q

Is ETS a risk factor for canine nasal tumors?

A

Maybe. No per Bukowski 1997; Yes per Reif 1998 –> in this study, dolichocephalic breeds had increased odds ratio of 2.0 (vs. 0.5).

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4
Q

What % of canine nasal tumors have been shown to express VEGFR? EGFR? (Shiomitsu 2009)

A

90% - VEGFR

50% - EGFR (EGFR1 62.5% in recent 2017 paper)

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5
Q

What % of dogs with dRT for acanthomatous ameloblastoma developed a RT-induced sarcoma?

A

3%

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6
Q

What are negative prognostic factors for nasal tumors in dogs?

A

age (> 10yrs), epistaxis, shorter duration of c/s, advanced stage, metastatic dz, SCC/undifferentiated carcinoma, failure to achieve resolution of c/s

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7
Q

Describe a modified Adam’s stage 3 nasal tumor?

A

nasal mass with orbital involvement or nasopharyngeal/SQ/submucosal mass

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8
Q

What is MST for canine nasal tumors tx with dRT followed by exenteration? (Bowles 2014)

A

457 days, similar to RT alone.

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9
Q

What is MST for stage 1 vs. stage 4 modified-Adam’s canine nasal tumor?

A

stage 1 - 23.4 months

stage 4 - 6.7 months

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10
Q

Which factor most significantly affects survival in dogs with nasal carcinomas without treatment?

A

Epistaxis

88d vs. 224d

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11
Q

What is a laryngeal oncocytoma?

A

Rhabdomyoma

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12
Q

In cats with nasal LSA, what % develop LSA elsewhere?

A

13-16%

So systemic therapy may be warranted, but unclear on timing.

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13
Q

Which molecular imaging biomarker was most predictive of PD for nasal tumors treated with dRT (using IMRT)? (Bradshaw 2015)

A

FLT (biomarker for cell proliferation) – thymidine analogs so markers for DNA synthesis (thymidine kinase - TK-1 expressed during S phase and higher in most cancer cells)

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14
Q

What is the prognosis for untreated nasal carcinomas?

A

3-4 months (Rassnick 2006, Morris 1994)

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15
Q

What was the MST for dogs with intranasal carcinomas treated with DOX/carbo (most recent study - Woodruff 2019)?

A

234d (7.8mo) compared to 7mo for Langova 2004

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16
Q

How does MRI differ from CT in size and staging of nasal tumors (Lux 2017)?

A

MRI estimated larger tumor volume in 5/6 dogs but there was still 5/6 agreement of tumor stage b/w CT and MRI

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17
Q

What was sensitivity of squash prep compared to hitopath for nasal tumor biopsies?

A

Sn 94%, Sp 81%

Most errors were LSA vs. lymphoid hyperplasia

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18
Q

What was the conclusion of study looking at RTK receptor expression in K9 nasal carcinoma? (Hocker 2017)

A

Phosphorylation of VEGFR2, PDGFR-alpha, PDGFR-beta, and c-KIT was NOT observed in any samples (carcinoma or normal). Conclude that Palladia effects occur through inhibition of unidentified RTK pathways.
(EGFR1 may be a target due to expression in 62.5%)

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19
Q

What is expression of COX-1 and COX-2 in normal nasal epithelium and nasal tumors? (Borzacchiello 2004)

A

COX-1 in normal nasal mucosa, rare in tumors

COX-2 strongly expressed in majority of tumors (in another study, Kleiter 2004, 81% expressed COX-2)

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20
Q

What variability was observed in RT planning amount 4 radiation oncologists? (Christensen 2016)

A

up to 50%

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21
Q

What % of cases exhibited late effects following single SRS dose for nasal tumors? (Kubicek 2016)

22
Q

What was the overall MST for nasal tumors with SBRT? MST for carcinoma, sarcoma, OSA? (Kubicek 2016)

A

Overall - 8.5mo

Carcinoma 10.4mo, sarcoma 10.7mo, OSA 3.1mo

23
Q

Did firocoxib improve survival when combined with RT? Did it improve QOL? (Cancedda 2015)

A

No improvement in survival, did improve QOL per owner survey.

24
Q

In a study evaluating re-irradiation of nasal carcinoma, what was the response time to the first tx? What was the overall MST? (Gieger 2013)

A

First tx - 114d (3.8mo)

OST - 453d (1.2y)

25
Q

What was the overall MST for intranasal sarcomas treated with RT? (Sones 2012)

A

444d (1.2y)
3 protocols used: daily, M/W/F, palliative
Survival time: OSA > FSA > CSA

26
Q

What % of dogs had complete resolution of signs with palliative RT? What % had partial resolution? (Tan-Coleman 2012)

A

78% CR, 16.5% PR = 94.8% ORR

27
Q

What was the median response to pRT for nasal tumors? (Tan-Coleman 2012)

A

178d (6mo) – note that this is what we quote

28
Q

What was the median response to a second course of pRT for nasal tumors? (Tan-Coleman 2012)

29
Q

In dogs that had re-irradiation with curative intent (52Gy first tx and 36Gy second tx), what was the median response to first tx and median response to second tx? (Bommarito 2011)

A

1st - 513d (1.4y)
2nd - 282d (0.8y)

Severe late effects in 2/9 dogs - blind

30
Q

What treatment provided the best outcome for dogs with intranasal lymphoma? RT, chemo, or both? (George 2016)

A

Both - 455d
RT alone - 375d, chemo alone - 175d
Conclusion: best to include RT

31
Q

What % of phosphorylated VEGFR, PDGFR-a, PDGFR-B, and c-KIT were seen in nasal carcinoma?

A

Phosphorylation of these receptors were not observed. Authors concluded that response to Palladia must be through other RTK. (Hocker 2017)

32
Q

What is the overall MST with CT-guided imaging for dRT? 1yr survival? 2yr survival?

A

11-19.7mo
1yr - 37-60%
2yr - 14-48%

33
Q

What is the Sn/Sp of CT for detecting LN metastasis from oral/nasal cancer?

A

Low Sn, fairly high Sp. No independent CT factors were predictive.
For mand/retro: Sn 12.5%/10.5%; Sp 91.1%/96.7%

34
Q

What was MST of slow release cisplatin IM combined with RT for nasal tumors? How was this tolerated? (Lana 2004)

A 
MST 474d (1.3y)
Well-tolerated
35
Q

How did RT + exenteration compare to RT alone? (Adams 2005)

A

RT + exenteration - 47.7 mo; had more late complications (rhinitis, osteomyelitis/necrosis)
RT alone - 19.7 mo

36
Q

What was RR and MST of cisplatin alone for nasal tumors? (Hahn 1992)

A

RR 27%, MST 5 months

37
Q

What is the met rate of nasal tumors?

A

30-50% but late in course of disease

38
Q

What is modified Adams stage 1?

A

tumor confined to one nasal passage or sinus with no bone involvement

39
Q

What is modified Adams stage 2?

A

any bone involvement (beyond turbinates) but no evidence of orbit or SQ mass

40
Q

What was duration of survival for dogs treated with IMRT, 2.4 x 10Gy? (Lawrence 20120)

A

420d (1.2y)

Similar to historic controls and had profound decrease in acute SEs

41
Q

What was the median PFS and 1 and 2 year PFS for 3x10 Gy (followed for 1 year)? (Gieger 2017)

A

PFS 354d

1 yr and 2 yr PFS were 49% and 39%

42
Q

What was the MST and 1 and 2 yr survival for 3x10 Gy (followed for 1 year)? (Gieger 2017)

A

MST 586d

1 yr and 2 yr MST 69% and 22%

43
Q

Are cat nasal planum SCC responsive to radiation?

44
Q

Did cats tolerate an accelerated hypo fractionated RT protocol for nasal planum squam?

A

Yes, MST 916d (2.5y)

45
Q

What CT features are more likely to be associated with malignant nasal tumor in cats?

A

abnormal MRPLN hilus and bone lysis

46
Q

High expression of ____ in nasal tumors was associated with poor response to tx and shorter survival times? (Fu JVIM 2014)

47
Q

What is the MST for a dog with nasal carcinoma without treatment?

A

95d (3. 2 months)

48
Q

What is the MST for dogs with nasal tumors treated with surgery alone?

A

3-6 months

49
Q

What is the median duration of control for dogs treated with dRT?

50
Q

T/F: IMRT results in a longer MST than 3DCRT in nasal tumors?

A

False

Lawrence paper

51
Q

T/F: Duration of c/s <90d correlates with longer survival with pRT.

Onco Board Review 2 (20 decks)

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