RT Protocols

Question 1

TCC bladder +/- urethra +/- prostate
Definitive RT

Answer 1

IMRT - 20 doses of radiation therapy on a Monday through Friday schedule

Question 2

TCC bladder +/- urethra +/- prostate
Palliative therapy

Answer 2

Palliative radiation therapy with 5 fractions +/- systemic chemotherapy

Question 3

STS Grade 1, excised with narrow margins
Definitive RT

Answer 3

SBRT 1-3 fractions

Question 4

STS Grade 3, excised with narrow margins
Definitive RT

Answer 4

SBRT 1-3 fractions
+/- systemic chemotherapy

Question 5

Feline Oral SCC
Definitive Treatment

Answer 5

Accelerated radiation therapy with 14 fractions given on a 2 times a day basis
CBC on day 1 and 5 of treatment
Carboplatin 95 mg/meted squared on day 1 and 5
Esophagostomy tube at the rDVM or specialist

Question 6

Feline Oral SCC
Palliative Treatment

Answer 6

Palliative radiation therapy with 5 fractions ×4 Gray = 20 Gray given on a Monday-Friday schedule

Question 7

Mast Cell Tumor of the Muzzle/Face
Definitive Therapy

Answer 7

Definitive therapy:
Surgical excision with wide margins

If surgical excision is not feasible or desired, intensity modulated radiation therapy with 20 fractions or stereotactic body radiosurgery
CT scan for planning

And/or
Systemic chemotherapy

:

Question 8

Mast Cell Tumor of the Muzzle/Face
Palliative therapy

Answer 8

Palliative radiation therapy with 5 fractions ×4 Gray = 20 Gray

Question 9

Pituitary Macroadenoma
Definitive therapy

Answer 9

CT scan for planning
Mannitol 1 g/kilogram preanesthesia
Stereotactic radiosurgery 3 fractions x 8 Gray = 24 Gray given with a minimum of 48 hours between doses within 7 days
Intranasal midazolam 0.35 mg/kilogram, 2 doses to be given as needed

Fluid rate 10 mL/kilogram/hour

Question 10

Infiltrative Lipoma/liposarcoma
Definitive therapy

Answer 10

Definitive therapy:
Intensity modulated radiation therapy with 20 fractions ×2.5 Gray = 50 Gray on a Monday-Friday schedule
CT scan for planning
Or
If IMRT is not feasible, stereotactic body radiosurgery with 3 fractions ×8 Gray with those intensification within the central aspect of the tumor
CT scan for planning
(wispy margins make IMRT&raquo_space; SBRT)

Question 11

Infiltrative Lipoma/liposarcoma
Palliative therapy

Answer 11

Palliative radiation therapy with 5 fractions

Question 12

Prostatic Carcinoma
Definitive therapy

Answer 12

CT scan for planning
Stereotactic body radiosurgery with 3 fractions if located in the prostate and urethra and no bladder involvement
If bladder involvement, intensity modulated radiation therapy with 20 fractions
Systemic chemotherapy

Question 13

Prostatic Carcinoma
Palliative therapy

Answer 13

Palliative radiation therapy with 5 fractions
+/- Systemic chemotherapy

Question 14

Canine Oral Melanoma, incompletely excised

Answer 14

Definitive therapy:
Scar revision with wide margins if feasible
Or
Definitive radiation therapy with SBRT 5 fractions OR IMRT 6 fractions
CT scan for planning

Melanoma vaccine if melanoma

Question 15

Nasal Planum SCC (feline)
Definitive Therapy

Answer 15

Nose-ectomy
Or
Strontium plesiotherpay if the facility is available
Or
Stereotactic body radiosurgery with 3 fractions

Question 16

Nasal Planum SCC (feline)
Palliative Therapy

Answer 16

Palliative radiation therapy with radiation on day 1, 7, and 21
Carboplatin 95 mg/m2 on day 1 and 21

Question 17

Brain tumor (ex meningioma)
Definitive therapy

Answer 17

Mannitol 1 g/kilogram preanesthesia
Stereotactic radiosurgery 3 fractions ×8 Gray given on nonconsecutive days of a week
Intranasal midazolam 0.35 mg/kilogram, 2 doses to be given as needed

Fluid rate 10 mL/kilogram/hour

Question 18

Feline injection site sarcoma (STS) grade 1
Definitive therapy

Answer 18

IMRT 18-22 fractions

Question 19

Feline Nasal Tumor
Definitive therapy

Answer 19

Stereotactic body radiosurgery with 1 fraction of 18Gy

Question 20

Canine Nasal Tumor
Definitive therapy

Answer 20

Stereotactic body radiosurgery with 3 fractions of 10Gy

Question 21

Nasal Tumor
Palliative therapy

Answer 21

Palliative radiation with 5 fractions

Question 22

Lingual Melanoma
Definitive therapy

Answer 22

Intensity modulated radiation therapy with 6 fractions × 6 Gray given on a 2 times a week basis to the lingual region as well as the mandibular lymph nodes

Melanoma vaccine

Question 23

Canine acanthomatous ameloblastoma
Definitive therapy

Answer 23

Surgical excision with wide margins
Or

Surgical debulking followed by definitive radiation therapy
Or

Stereotactic body radiosurgery with 5 fractions

Question 24

Canine acanthomatous ameloblastoma
Palliative therapy

Answer 24

Palliative radiation therapy with 5 fractions

Question 25

Canine Appendicular STS Definitive therapy

Answer 25

Surgical excision with wide margins Or Surgical debulking followed by SBRT x 1-2fr Or if surgery is not feasible, SBRT x 3 fr

Question 26

Canine Oral STS Definitive therapy

Answer 26

Surgical excision with wide margins Or Surgical debulking followed by definitive radiation therapy (IMRT x 20fr, or SBRT x 5fr) Or Intensity-modulated radiotherapy with 20 fractions or Stereotactic body radiosurgery with 5 fractions

Question 27

Canine Oral STS Palliative therapy

Answer 27

Palliative radiation therapy with 5 fractions ×4 Gray = 20 Gray

Question 28

Canine Soft Palate Melanoma Definitive Therapy

Answer 28

Stereotactic body radiosurgery 5 fractions ×5.6 Gray given within 1 week to oral cavity and both submandibular lymph nodes

Question 29

Canine Thyroid Carcinoma Definitive Therapy

Answer 29

Surgical excision with wide margins OR Surgical debulking plus radiation therapy IMRT x 20 fractions Or If surgery is not feasible or desired, SBRT x 3 fractions

Question 30

Canine AGASACA narrowly excised Definitive Therapy

Answer 30

IMRT 19 fr x 2.5 Gy to the anal region and draining lymph nodes Follow with systemic chemotherapy OR SBRT with 5fr if schedule doesn't allow for IMRT

Question 31

Tonsillar SCC Definitive Therapy

Answer 31

Surgical excision with wide margins if possible AND SBRT x 3-5 fractions AND systemic chemotherapy

Question 32

Feline Thymoma Definitive Therapy

Answer 32

SBRT x 2-3 fractions OR Surgical excision followed by SBRT