tumor specific LC part 3 Flashcards
most common tumor of the nasal planum in cats
SCC
rare in dogs
cause of nasal planum scc
UV induced
may be malignant transformation from keratosis or carcinoma in situ
typically cats have white coat
breeds associated with scc
cats - white cats
dogs - goldens and labs 50-76% of cases
treatment of nasal planum scc
nasal planum resection
may need to remove incisive or maxillary bone sit sarcoma or mct
px is good but may recur or met
what is most important for recurrence of nasal plant tumors
complete resection
even with rt some dogs had recurrence within 9 weeks
nasal planecotmy in cats with scc recurrence, dfi, mst
less than 10% of cats had recurrence
DFI 426 - 594 d ~14-20 mo
mst 530 - 673 days ~18-22 mo
surgical curettage and diathermy has been used with rr of 6% for cosmesis
median time to recurrence in patients treated with primary RT or adjuvant RT
nasal squame????
2-3 months
orthovoltage rt in cats for scc pf
megvoltage rt in cats for scc pfi
protons rt in cats for scc
ortho - 1 year pf 60%
mega - pfi 361-916 d ~12-30 mo; mst 961(32 mo)
protons - mst 946d (11.5 mo) pf rate 64%
prognostic factors for cats with nasal planum scc treated with rt
ortho - stage and proliferative fraction
mega - larger size had 5.5 - 6 risk of dying
strontium penetration
depth of 3 mm
response in cats with nasal planum scc treated with strontium
cr - 88%
recurrence - 20%
new lesions in diff location - 33%
MPFI 1710 (~4.5 yr)
1 year df 89%
3 year df 82%
MST 3076 (8.5 yr)
intralesional chemo for feline nasal planum scc
carbo typically
cr 73%
local recurrence 30%
PFS 16 mth
electro chemo for feline nasal planum scc
CR 75%-86%
dfi 7-36 mths
cryosurgery for feline scc
must be smaller than 5 mm, superficial, non invasive
response rate 81%
local recurrence 17% - 73%
DFI 6mth - 26.7 mth
Photodynamic therapy
use of applied light after the administration of a photosensitizer.
The photosensitizer is activated by the light to form free radicals, which results in the induction of cell death. damages and restricts microvasculature inducing immune response
Due to the limited penetration of light into the tissue, the treatment depth is considered 5 mm or less
photodynamic therapy using 5-aminolevulinic acid (5-ALA) as a photosensitizer in cats with nasal planum scc
ORR 96% 49-85% CR
51% recurrence
rate of CR was dependent on stage
CR was noted in 100% of noninvasive tumors measuring <1.5 cm in diameter, 56% of invasive tumors measuring <1.5 cm in diam- eter, and 18% of invasive tumors measuring >1.5 cm in diameter
what is photodynamic therapy used for
nasal planum scc, K9 urinary tumros, equine sarcoids
what are the photosensitizers used in PDT
5-ALA and mTHPC
Nasal tumor SRT- what true
a. sarcomas do better than carcinomas
b. most common side effect oronasal fistula
c. IMRT leads to improved ST for stage I-VI Adams
a. all carcinoma vs all sarcoma - no difference in survival but grouping scc,carcin and undifferentiated carcinoma was worse
b. oronasal fistula can happen with srt - risk worse with surgery
c. stage 4 worse but overall mst improved compared to standard therapy 305 d vs
sinonasal tumor distribution
older >10 but report in dogs young as 9 mths
1% of tumors overall
medium to large breeds may be more affected
risk factors for sinonasal tumors
dolichocephalic breeds (long-nosed) or dogs living in urban envi- ronments, with resultant increased nasal filtering of pollutants, may be at higher risk for developing nasal cancer
tobacco smoke- conflicting reports
carcinomas make up what percent of sinonasal tumors
2/3 - adenocarcinoma, scc, undifferentiated carcinoma
sarcomas - fibrosarc, chondorsarc, osa, and undifferentiated make up most of the rest
rarely - mct, lsa, tvt
extremely rare - hsa, melanoma, neuroendocrine carcinoma, nerve sheath, neuroblastoma, histocytoma, MLO, rhabdo, leiomyo
met rate of nasal tumors
generally low but may be higher at death 40-50% - regional LN and lungs
less commonly bones, kidney, liver, skin, and Brain
mutations seen in sinonasal tumors
60% adenocarcinomas had mutated p53
COX-2 in epithelial tumors
50% EGFR in carcinomas
90% VEGR in carcinomas - tkis good tx
71% PDGFRα 40% PDGFRb - tkis good tx