Radiotherapy For Brain and Nasal Tumors

Brain tumors:

(Meningiomas, pituitary macrotumors, other brain tumors and GME)

Meningiomas and pituitary tumors are generally more radioresponsive than other types of brain tumors.

The treatment of choice for Feline meningioma is surgery when feasible (depending on location). Radiation therapy is effective when surgical resection is not possible.

The treatment of choice for Canine meningioma is either a combination of surgery and radiation therapy, or radiotherapy alone.

Radiation therapy is an effective treatment of Pituitary macrotumors and has become the safest and most common treatment. The response and survival time is usually dependent on the severity of neurological signs.

While not a neoplastic process, some GME (granulomatous meningoencephalo-myelitis) cases unresponsive to cortico-steroids have responded well to irradiation.

Irradiation of other Intracranial tumors (most without a definite diagnosis) has significantly increased survival time compared to strictly medically-treated cases. Response to treatment is usually dependent on the severity of neurological signs (the more neurological impairment, the worse the prognosis).

Nasal tumors:

Nasal, paranasal sinuses, and nasal plenum

For the most part, studies on tumors of thenasal cavity and paranasal sinuses in canines have been grouped together. Aggressive surgery followed by orthovoltage therapy has produced the best survival times (median of approximately 23 months). When using megavoltage therapy, prior surgery decreases the success rate (mean and median survival of approximately 21 and 13 months respectively).

    In a recent study, megavoltage therapy combined with (OPLA)-cisplatin (not yet available on the market) has increased survival times to a median of some 24 months.

    In the cat, similar survival times have been achieved as found in the dog.

    Little data is available on Solitary nasal lymphoma in dogs, due to the rarity of cases. Nasal lymphoma in cats is well documented and has been successfully treated with radiation therapy, with and without chemotherapy, resulting to a median survival time of approximately 2 years. A similar survival time was achieved in an isolated canine case treated with megavoltage radiation combined with (OPLA)-cisplatin.

    Squamous cell carcinoma (SCC) of the nasal plenum in felines is most successfully treated with surgery (the use of radiation therapy depends on the tumor margins). Cases treated with radiation therapy alone have also responded well. The prognosis and disease-free interval depends largely on the clinical stage at the start of treatment.

    Unfortunately, SCC of the nasal plenum in canines is more resistant to radiation therapy than SCC of the nasal cavity. Ultimately these tumors are best approached very aggressively with a combination of radiation, surgery and chemotherapy. They may be treated with aggressive surgery (+/- radiation depending on the margins) if found when still relatively superficial. Radiation alone does not appear promising.


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