Efficacy of radiation therapy for incompletely resected grade-III mast cell tumors in dogs: 31 cases (1987–1998)

Hahn, Kevin A.; King, Glen K.; Carreras, Janet K.

doi:10.2460/javma.2004.224.79

Cited by 63 publications

(81 citation statements)

References 24 publications

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“…A recent report by Hahn et al described a positive outcome in dogs with high-grade MCT treated with RT alone. Of note, all of these dogs received PNI [13]. The results this group obtained are significantly different than those reported by others employing surgery [2,3,20,22,25].…”

Section: Discussioncontrasting

confidence: 53%

“…To our knowledge, this is the first study that has demonstrated a statistical association between mucous membrane origin and outcome in canine MCT. Some studies have identified tumour size as a prognostic factor in canine MCT [13,19]. Unfortunately, the majority of patients identified in this study underwent surgery prior to referral, and tumour size was thus often impossible to determine retrospectively.…”

Section: Discussionmentioning

confidence: 99%

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Outcome and Prognostic Factors Following Adjuvant Prednisone/Vinblastine Chemotherapy for High-Risk Canine Mast Cell Tumour: 61 Cases

2006

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ABSTRACT. The medical records of 61 dogs with MCT at high risk for metastasis that were treated with prednisone and VBL following excision +/-radiation therapy were reviewed, and median disease-free interval (DFI), median overall survival time (OS) and prognostic factors assessed. Adverse effects, mostly mild, were noted in 26% of patients, usually after the first VBL dose. 6.5% experienced severe neutropenia. The DFI was 1305 days, and the OS was not reached, with 65% alive at 3 years. 100% of dogs with "high-risk" grade II MCT were alive at 3 years. The OS for dogs with grade III MCT was 1374 days. Histologic grade, location (mucous membrane vs. skin) and use of prophylactic nodal irradiation predicted outcome. Prednisone and VBL chemotherapy is well tolerated, and results in good outcomes following surgery in dogs with MCT at high risk for metastasis. High-grade and mucocutaneous tumors had a worse outcome, and the use of prophylactic nodal irradiation appeared to improve outcome in this group of dogs. KEY WORDS: canine, mastocytoma, Prednisone, vinblastine.J. Vet. Med. Sci. 68(6): 581-587, 2006 Mast cell tumour (MCT) represents the most common malignant cutaneous tumour in the dog [29]. High-grade or undifferentiated MCT (Patnaik grade III) comprise 29 to 40% of all MCT [2,14,22]. In addition to local infiltration, they have a reported metastatic rate of 55 to 96%, and are more likely to result in tumor-related death than are low-or intermediate-grade MCT [29]. While some discordance exists in the literature, patients with MCT of any grade involving the regional lymph node (LN) or arising from a mucous membrane (e.g. gingiva, perineum, prepuce, nailbed) may also be at higher risk for eventual death from MCT [1,10,[28][29][30]. Thus, local therapies alone may be suboptimal for tumour control in these patients.Survival times after surgery alone for high-grade MCT were reported in early studies as 15% at seven months, 6% at 48 months, and a median survival time (MST) of 13 weeks [2,3,22]. More recent studies have reported a MST of approximately 9 months with resection alone in dogs with high-grade MCT [20,25].Several studies have evaluated chemotherapy for the treatment of measurable MCT, and response rates from 7% to 78% have been documented [8,10,17,18,23,28]. However, few studies have evaluated the efficacy of chemotherapy as adjuvant treatment for MCT [7,28].Vinblastine (VBL) is an antimicrotubule alkaloid used in the treatment of hemolymphatic neoplasia in dogs [12], and various human malignancies [24]. We previously reported the results of a study employing prednisone/VBL for the treatment of dogs with gross, microscopic and "high-risk" MCT. An objective response rate of 44% was reported in dogs with gross disease, and there was suggestion that dogs receiving prednisone/VBL following surgery had a favorable clinical outcome compared with historical controls receiving local therapy alone [28]. However, the clinical characteristics of these patients were variable, and a relatively small number were treat...

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Outcome and Prognostic Factors Following Adjuvant Prednisone/Vinblastine Chemotherapy for High-Risk Canine Mast Cell Tumour: 61 Cases

2006

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“…After surgery, local recurrence rates for MCT range from 10 to 50% in the literature 2,3,25‐27 . However, status of the surgical margins was not known in most of these studies.…”

Section: Discussionmentioning

confidence: 99%

Treatment of canine mast cell tumours with vinblastine, cyclophosphamide and prednisone: 35 cases (1997–2004)

Camps‐Palau¹,

Leibman

Elmslie³

et al. 2007

Vet Comparative Oncology

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The purpose of this retrospective study was to determine the efficacy and toxicity of a combined protocol of vinblastine, cyclophosphamide and prednisone (VCP) in 35 dogs with mast cell tumours (MCTs). Eleven dogs had measurable disease (group 1) and 24 dogs had incompletely excised MCT or were at high risk for metastasis (group 2). Five patients in group 1 achieved complete response, two partial responses, two stable diseases and two progressive diseases. The median progression-free survival time (PFST) for group 1 and 2 dogs was 74 and 865 days, respectively. The median overall survival time (OST) for group 1 and 2 dogs was 145 and >2092 days, respectively. Significant negative multivariate prognostic factors included macroscopic disease and reduced vinblastine (VBL) treatments for PFST, and presence of MCT in bone marrow analysis, Patnaik grade III MCT and reduced VBL treatments for OST. Toxicity was infrequent and self-limiting. This study suggests that the VCP protocol should be considered as an option in the treatment of MCT in dogs.

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“…Unfortunately, many dogs develop MCTs on distal limbs or on the head in sites where complete surgical excision cannot be achieved with preservation of the limb or the anatomy of the area. Post‐operative radiotherapy appears to increase the survival time of solitary grade II and grade III MCTs following incomplete surgical excision (Al‐Sarraf et al ., 1996; Frimberger et al ., 1997; Hahn et al ., 2004). In some cases, the diffuse and/or extensive nature of the tumour mass precludes even cytoreductive surgery, and these cases are often referred for radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Treatment of canine mast cell tumours with prednisolone and radiotherapy

Dobson

Cohen

Gould

2004

Vet Comparative Oncology

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This retrospective study describes 35 dogs with non-resectable, grade I-III mast cell tumours on the head or limb treated with prednisolone (40 mg m(-2) daily) for 10-14 days prior to radiotherapy (4 x 800 cGy fractions at 7-day intervals) from a 4 MV linear accelerator. Prednisolone was continued at a reduced dose rate (20 mg m(-2)) during radiotherapy and for 2 months or longer afterwards. Eighteen of 24 tumours (75%) decreased in size in response to prednisolone treatment. By 6-8 weeks following radiotherapy, 12 dogs had achieved a complete remission and 19 a partial response. Two tumours remained static and two progressed during the course of treatment. The overall response rate was 88.5%. With long-term follow-up, 11 dogs experienced local recurrence (n = 4), metastasis (n = 5) or both (n = 2). The median progression-free interval was 1031 days (95% CI 277.44-1784.56, Kaplan-Meier), with 1- and 2-year progression-free rates of 60 and 52%, respectively. Tumour grade did not predict the prognosis for this group of dogs, but tumour location did affect the outcome. Dogs with tumours located on the limb survived longer than those with tumours on the head. The combination of prednisolone with radiotherapy appears to have a useful role in the management of measurable mast cell tumours sited on the head and distal extremities.

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Efficacy of radiation therapy for incompletely resected grade-III mast cell tumors in dogs: 31 cases (1987–1998)

Abstract: Without further treatment, incompletely excised grade-III mast cell tumors have high local-regional recurrence; local-regional treatment with radiation may effectively be used to manage many such tumors.

Cited by 63 publications

References 24 publications

Outcome and Prognostic Factors Following Adjuvant Prednisone/Vinblastine Chemotherapy for High-Risk Canine Mast Cell Tumour: 61 Cases

Outcome and Prognostic Factors Following Adjuvant Prednisone/Vinblastine Chemotherapy for High-Risk Canine Mast Cell Tumour: 61 Cases

Treatment of canine mast cell tumours with vinblastine, cyclophosphamide and prednisone: 35 cases (1997–2004)

Treatment of canine mast cell tumours with prednisolone and radiotherapy

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