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A prospective pilot study on early toxicity from a simultaneously integrated boost technique for canine sinonasal
1Division of Radiation Oncology, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Veterinary and Comparative Oncology
|May 16, 2018
Summary
Image-guided intensity-modulated radiation therapy (IMRT) with a simultaneously integrated boost (SIB) shows promise for treating canine sinonasal tumors, with acceptable early side effects. Further research is needed to confirm tumor control and late toxicity risks.
Area of Science:
- Veterinary Oncology
- Radiation Oncology
- Medical Physics
Background:
- Canine sinonasal tumors often experience local treatment failure.
- Previous integrated boost techniques were limited by high acute toxicity.
- Intensity-modulated radiation therapy (IMRT) offers potential for advanced dose escalation.
Purpose of the Study:
- To evaluate the clinical feasibility and toxicity of a simultaneously integrated boost (SIB) protocol using image-guided IMRT for canine sinonasal tumors.
- To test the hypothesis that dose escalation is clinically tolerable with modern radiation techniques.
Main Methods:
- Prospective pilot study involving 9 dogs with sinonasal tumors.
- Application of a 10x4.2 Gy protocol to the planning target volume (PTV) with a 20% SIB to the gross tumor volume (GTV).
- Daily image guidance and rigid patient positioning for treatment delivery.
Main Results:
- Mild ophthalmologic complications were observed.
- 33% of dogs experienced self-limiting grade 3 mucositis, managed medically.
- No instances of skin or mucosal ulceration, hemorrhage, or necrosis were reported.
Conclusions:
- The SIB protocol delivered with image-guided IMRT is clinically tolerable for canine sinonasal tumors.
- The potential for increased tumor control probability requires further investigation.
- Long-term toxicity associated with this dose escalation needs to be assessed.
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