Radiotherapy is often considered in the management of canine multilobular osteochondrosarcoma (MLO), but its efficacy against bulky MLO tumours is poorly described. This retrospective case series describes the clinical outcomes of pet dogs with MLO treated with a stereotactic radiation therapy (SRT) prescription of 30 Gy in three consecutive daily 10 Gy fractions. Dogs with an imaging (via computed tomography [CT] scan) and/or pathologic diagnosis of MLO were included. Patient demographics, tumour characteristics, radiation plan dosimetry, toxicity and outcome data were obtained retrospectively from the records. The median progression‐free survival time (MPFST) and median overall survival time (MST) were calculated using a LOGLOG test. Eight dogs were included. None had evidence of metastasis at the time of SRT. Clinical signs associated with the MLO included a mass noted by owner, stertor, vestibular signs, exophthalmos and abnormal mentation. Of the five dogs that had CT scans performed 3 to 9 months after SRT, tumour volume decreased by 26% to 87% in four dogs and increased by 32% in one dog. Late radiation toxicity was documented in three dogs (VRTOG Grade 1 skin and/or ocular, n = 2; Grade 3 central nervous system, n = 1). Confirmed local disease progression (n = 3; two were treated with a second course of SRT) and suspected pulmonary metastasis (n = 2) occurred 90 to 315 days after SRT. The MPFST was 223 days (interquartile range [IQR]: 144.5‐276.5 days). The MST was 329 days (IQR: 241.5‐408 days). This protocol was well‐tolerated, but the duration of response was short‐lived.
Staging and therapeutic planning for dogs with malignant disease in the popliteal lymph node are based on the expected patterns of lymphatic drainage from the lymph node. The medial iliac lymph nodes are known to receive efferent lymph from the popliteal lymph node; however, an accessory popliteal efferent pathway with direct connection to the sacral lymph nodes has also been less frequently reported. The primary objective of this prospective, anatomic study was to describe the frequency of various patterns of lymphatic drainage of the popliteal lymph node. With informed client consent, 50 adult dogs with no known disease of the lymphatic system underwent computed tomographic lymphography after ultrasound-guided, percutaneous injection of 350 mg/ml iohexol into a popliteal lymph node. In all 50 dogs, the popliteal lymph node drained directly to the ipsilateral medial iliac lymph node through multiple lymphatic vessels that coursed along the medial thigh. In 26% (13/50) of dogs, efferent vessels also drained from the popliteal lymph node directly to the internal iliac and/or sacral lymph nodes, coursing laterally through the gluteal region and passing over the dorsal aspect of the pelvis. Lymphatic connections between the right and left medial iliac and right and left internal iliac lymph nodes were found. Based on our findings, the internal iliac and sacral lymph nodes should be considered when staging or planning therapy for dogs with malignant disease in the popliteal lymph node.
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