Hypofractionated radiotherapy for macroscopic canine soft tissue sarcoma: A retrospective study of 50 cas-es treated with a 5x6 gy protocol with or without metronomic chemotherapy

Wide surgical resection or a marginal/incomplete resection followed by full-course radiation therapy is the current standard of care for canine soft tissue sarcoma. The purpose of this retrospective, descriptive, bi-institutional study was to determine the effectiveness and toxicity of a hypofractionated 5 × 6 Gy protocol on macroscopic canine soft tissue sarcoma in terms of progression-free interval (PFI) and overall survival (OS), and to identify prognostic factors for patient outcome. Dogs with macroscopic soft tissue sarcoma irradiated with 5 × 6 Gy were eligible for the study. Progression-free interval and OS were compared with respect to different tumor and patient characteristics by the Kaplan-Meier method and multivariable Cox regression analysis. Fifty dogs with macroscopic disease were included. All dogs received the same radiation therapy protocol; part of the group (n = 20) received postradiation metronomic chemotherapy. Median PFI for all cases was 419 days (95% confidence interval (CI): 287-551) and median OS was 513 days (95% CI: 368-658). Dogs with tumors on the limbs had significantly longer PFI and OS, compared with head or trunk. Increasing tumor burden decreased OS. The addition of metronomic chemotherapy yielded a significantly longer OS (757 days (95% CI: 570-944) compared with dogs that did not receive systemic treatment (286 days (95% CI: 0-518), (P = 0.023)), but did not influence progression-free interval. Toxicity was low throughout all treatments. The 5 × 6 Gy radiation therapy protocol was well tolerated and provided long PFI and OS in dogs with macroscopic soft tissue sarcoma

The Montescano Effect: Being Resilient Through Challenges and Changes

Hospitals are places where you live a piece of your life, no matter you are healthcare professional, patient or caregiver. This editorial describes the humanistic approach to medicine adopted by the Montescano Institute, an Italian research and clinical hospital dedicated to the rehabilitation of neurological and cardiopulmonary diseases according to updated international guidelines. The aim of these “notes from the field” is to provide a sound example of humanistic clinical practice before, during and after the challenges posed by the COVID-19 pandemic. In this environmental each individual is indeed engaged in relationships, which trigger mutual empowerment and growth

Megavoltage radiotherapy for the treatment of degenerative joint disease in dogs: results of a preliminary experience in an Italian Radiotherapy Centre

The aim of the study was to evaluate the efficacy and toxicity of a low-dose radiotherapy treatment in dogs with osteoarthritis (OA). Inclusion criteria were dogs affected by OA of one or multiple joints, with lameness, previously treated with medical therapy and referred for radiotherapy because of chronic unresponsive pain. After suspension of medical therapy, dogs underwent external beam radiotherapy treatments delivered in three fractions of 2 Gy each. Four of these dogs had one (three dogs) to four (one dog) additional courses of radiation. Medical records were reviewed and follow-up information was collected by clinical recheck and owners interview. Twenty-five dogs matched the inclusion criteria; among them, 21 had one course of RT and 4 underwent multiple treatments, respectively 218, 266, 39, and 1,384 days after the first treatment. Clinical improvement was observed in 92% of patients with median benefit duration of 356 days after the first treatment, and 418 days after the second treatment. No side effects were recorded. In this group of patients, radiotherapy was effective, well tolerated, and repeatable, leading to an improvement of quality of life in dogs with degenerative joint disease unresponsive to medical treatments

Comparison of definitive-intent finely fractionated and palliative-intent coarsely fractionated radiotherapy as adjuvant treatment of feline microscopic injection-site sarcoma

Objectives The aim of this retrospective, bi-institutional study was to evaluate the progression-free interval in a cohort of cats with postoperative microscopic injection-site sarcoma (ISS) treated with two different radiotherapy protocols. Methods Included in the study were cats with ISSs undergoing macroscopic surgical removal and subsequent electron beam radiotherapy treatment with either a finely fractionated protocol (48 or 52.8 Gy over 4 weeks delivered in 12 or 16 fractions) or a coarsely fractionated protocol (36 Gy over 3 weeks administered in six fractions). Medical records were reviewed and follow-up information was collected. The Kaplan-Meier method and log-rank test were used to compare the progression-free interval (PFI) between the two protocols and to test the influence of many clinical variables. Results Fifty-nine cats were included; 38 underwent a finely fractionated protocol and 21 a coarsely fractionated protocol. PFI was not significantly different between the two groups. Overall PFI was 2000 days (2000 vs 540 days; P = 0.449). When only first-occurrence cases were included, median PFI was significantly longer in the finely fractionated group compared with the coarsely fractionated group (1430 vs 540 days; P = 0.007). In cats that underwent multiple surgeries PFI was not different between protocols (233 vs 395 days; P = 0.353). Conclusions and relevance Cats with primarily occurring ISSs appear to benefit from postoperative finely fractionated radiotherapy. The same benefit was not evident in cats that underwent multiple surgeries and we think a coarsely fractionated protocol would be indicated in these cases

Comparison of definitive-intent finely fractionated and palliative-intent coarsely fractionated radiotherapy as adjuvant treatment of feline microscopic injection-site sarcoma

Objectives: The aim of this retrospective, bi-institutional study was to evaluate the progression-free interval in a cohort of cats with postoperative microscopic injection-site sarcoma (ISS) treated with two different radiotherapy protocols. Methods: Included in the study were cats with ISSs undergoing macroscopic surgical removal and subsequent electron beam radiotherapy treatment with either a finely fractionated protocol (48 or 52.8 Gy over 4 weeks delivered in 12 or 16 fractions) or a coarsely fractionated protocol (36 Gy over 3 weeks administered in six fractions). Medical records were reviewed and follow-up information was collected. The Kaplan\u2013Meier method and log-rank test were used to compare the progression-free interval (PFI) between the two protocols and to test the influence of many clinical variables. Results: Fifty-nine cats were included; 38 underwent a finely fractionated protocol and 21 a coarsely fractionated protocol. PFI was not significantly different between the two groups. Overall PFI was 2000 days (2000 vs 540 days; P = 0.449). When only first-occurrence cases were included, median PFI was significantly longer in the finely fractionated group compared with the coarsely fractionated group (1430 vs 540 days; P = 0.007). In cats that underwent multiple surgeries PFI was not different between protocols (233 vs 395 days; P = 0.353). Conclusions and relevance: Cats with primarily occurring ISSs appear to benefit from postoperative finely fractionated radiotherapy. The same benefit was not evident in cats that underwent multiple surgeries and we think a coarsely fractionated protocol would be indicated in these cases

Outcome in dogs with advanced (stage 3b) anal sac gland carcinoma treated with surgery or hypofractionated radiation therapy

Stage 3b anal sac gland carcinoma (ASGC) can be life-threatening. A surgical approach is not always possible or may be declined. Dogs with stage 3b ASGC treated with surgery or conformal radiation therapy (RT) with 8 × 3.8 Gy (total dose 30.4 Gy, over 2.5 weeks) were retrospectively evaluated. Patient characteristics, median progression-free interval (PFI) and median survival time (MST) were compared. Twenty-eight dogs were included; 15 underwent surgery, 13 underwent RT. At the time of presentation, 21% showed life-threatening obstipation and 25% showed hypercalcaemia. PFI and MST for surgery cases were 159 days (95% CI: 135-184 days) and 182 days (95% CI: 146-218 days), both significantly lower than for RT cases with 347 days (95% CI: 240-454 days) and 447 days (95% CI: 222-672 days), (P = 0.01, P = 0.019). Surgery as well as RT led to a fast relief of symptoms. PFI and survival of surgical patients were significantly inferior to that of a comparable patient group treated with conformal hypofractionated RT

Megavoltage Radiotherapy for the Treatment of Degenerative Joint Disease in Dogs: Results of a Preliminary Experience in an Italian Radiotherapy Centre

The aim of the study was to evaluate the efficacy and toxicity of a low-dose radiotherapy treatment in dogs with osteoarthritis (OA). Inclusion criteria were dogs affected by OA of one or multiple joints, with lameness, previously treated with medical therapy and referred for radiotherapy because of chronic unresponsive pain. After suspension of medical therapy, dogs underwent external beam radiotherapy treatments delivered in three fractions of 2 Gy each. Four of these dogs had one (three dogs) to four (one dog) additional courses of radiation. Medical records were reviewed and follow-up information was collected by clinical recheck and owners interview. Twenty-five dogs matched the inclusion criteria; among them, 21 had one course of RT and 4 underwent multiple treatments, respectively 218, 266, 39, and 1,384 days after the first treatment. Clinical improvement was observed in 92% of patients with median benefit duration of 356 days after the first treatment, and 418 days after the second treatment. No side effects were recorded. In this group of patients, radiotherapy was effective, well tolerated, and repeatable, leading to an improvement of quality of life in dogs with degenerative joint disease unresponsive to medical treatments

Studio sulla biopsia tc-guidata del polmone con ago sottile nel cane e nel gatto

La diagnosi delle patologie polmonari sulla base dell’anamnesi e della visita clinica è spesso difficile. La diagnostica per immagini risulta essere di grande importanza in questo settore. La radiologia è stata considerata per molto tempo la tecnica di elezione per lo studio di queste malattie. Tuttavia spesso non è possibile differenziare una lesione infiammatoria/infettiva da una neoplastica. Risulta quindi necessaria una corretta diagnosi cito-istopatologica per avere una diagnosi accurata, una corretta prognosi ed un preciso piano terapeutico. In medicina umana la TC e la biopsia TC-guidata sono indicate in presenza di lesioni non adeguatamente visualizzate con altre procedure diagnostiche. Nel presente studio sono stati sottoposti a biopsia TC-guidata con ago sottile 30 cani e 9 gatti, di differente sesso, razza e dimensioni. In tutti gli animali sono stati eseguiti esame clinico, esami ematici e le radiografie del torace. Nel presente studio 32 campioni su 39 sono risultati diagnostici. Gli altri 7 casi o a causa di incertezza diagnostica, od in quanto contenevano solo sangue sono stati considerati non diagnostici. Non si sono riscontrate complicazioni gravi, solamente 5 casi di lieve pneumotorace.Diagnosis of pulmonary lesions on the basis of history and physical examination is often challenging. Diagnostic imaging is therefore of paramount importance in this field. Radiology has traditionally been considered the elective diagnostic procedure for these diseases. Nonetheless it is often not possible to differentiate inflammatory/infectious lesions from neoplastic disease. A correct cyto-histopathologic diagnosis is therefore needed for an accurate diagnosis and subsequent prognostic and therapeutic plan. In human medicine TC and TC-guided biopsy are indicated in the presence of lesions which are not adequately imaged with other diagnostic procedures. In the present study 30 dogs and 9 cats of different sex, breed and size underwent TCguided lung fine-needle aspiration. Clinical examination, haematology and chest radiography were performed on all animals. In this study 32 samples out of 39 were diagnostic. Other 7 cases either because of uncertainty or only blood was aspirated, were considered non diagnostic. Only mild pneumothorax was seen in 5 cases. No major complications were encountered