Radiation therapy communication: nasal passage and paranasal sinus lymphoma in a pony

An aged pony with extensive paranasal sinus and nasal passage B-cell lymphoma was treated with palliative radiation therapy. Sixteen gray were administered in two fractions, 7 days apart. A lateral field was used for the first fraction and a dorsal field for the second. Because of tumor being present in the left frontal sinus, gross tumor was knowingly excluded from the treated volume in the lateral field. The tumor regressed within 2 months and the pony remained free of clinical disease for 2.5 years. Acute, temporary blindness developed shortly after the second radiation fraction, but a direct causal relationship with the radiation therapy was not confirmed. The only radiation side effect was leukotrichia. Palliative treatment was successful in improving and prolonging the quality of life. These results suggest that localized equine B-cell lymphoma is radiosensitive, and that palliative radiation therapy is a reasonable consideration for large tumors, even when tumor volume prevents all gross tumor from being irradiated.