Evaluation of local toxic effects and outcomes for dogs undergoing marginal tumor excision with intralesional cisplatin-impregnated bead placement for treatment of soft tissue sarcomas: 62 cases (2009–2012)

Abstract

OBJECTIVE To evaluate outcomes for dogs following marginal tumor excision and intralesional placement of cisplatin-impregnated beads for the treatment of cutaneous or subcutaneous soft tissue sarcomas (STSs) and assess local toxic effects of cisplatin-impregnated beads in these patients. DESIGN Retrospective case series. ANIMALS 62 client-owned dogs. PROCEDURES Medical records were reviewed to identify dogs with STSs treated with marginal excision and intralesional placement of cisplatin-impregnated beads. Patient signalment; tumor location, type, and grade; dates of tumor resection and bead placement; number of beads placed; and concurrent treatments were recorded. Data regarding toxicosis at the bead site (up to the time of suture removal) and tumor recurrence were collected; variables of interest were evaluated for associations with these outcomes, and systemic adverse effects (if any) were recorded. RESULTS 24 of 51 (47%) evaluated dogs had toxicosis at bead placement sites (classified as mild [n = 12] or moderate [10] in most). Fifteen of 51 (29%) tumors recurred. Median disease-free interval was not reached for dogs with grade 1 and 2 STSs, whereas that for dogs with grade 3 STSs was 148 days. Disease-free survival rates of dogs with grade 1 and 2 tumors at 1, 2, and 3 years were 88%, 75%, and 64%, respectively. One dog was treated for presumptive systemic toxicosis but recovered with medical treatment. CONCLUSIONS AND CLINICAL RELEVANCE Cisplatin-impregnated beads were generally well tolerated; good results were achieved for dogs with grade 1 or 2 STSs. Prospective, controlled studies are needed to determine efficacy of this treatment for preventing recurrence of marginally excised STSs in dogs.

Soft tissue sarcoma in dogs: A treatment review and a novel approach using electrochemotherapy in a case series

“…Treatment side effects (eg, delays in wound closure, pathological fracture, wound dehiscence, local ulceration, need for ancillary treatments and so on) have been reported in the other studies that used radical surgical approach or adjuvant treatments for canine STSs (ie, radiation therapy and intralesional chemotherapy), and should be taken into account when evaluating the risk/benefit ratio of a treatment. 16,19,22,24 It should be noticed that in our study higher local treatment toxicity was associated with higher amplitude to electric distance ratio (1200 vs 1000 V/cm). This finding has never been reported neither in human nor in veterinary literature and probably needs to be carefully considered given the subjectivity nature of the toxicity scale.…”

“…When orthovoltage radiation therapy was coupled with low‐dose doxorubicin (used as radiosensitizer) on microscopic disease similar RR was observed (18%) . Cisplatin‐based local chemotherapy (either cisplatin biodegradable implants or cisplatin impregnated beads) has been applied as adjuvant treatment to marginal or incomplete surgery; however, data on local tumour RR differ between the two published studies (16.6%, 29%). The comparison between these results should be evaluated with caution due to the heterogeneity of the populations included.…”

“…Indeed, mast cell tumours are more prone to cause inflammation of the peritumoral tissues and local treatment side effects can be negatively affected. Treatment side effects (eg, delays in wound closure, pathological fracture, wound dehiscence, local ulceration, need for ancillary treatments and so on) have been reported in the other studies that used radical surgical approach or adjuvant treatments for canine STSs (ie, radiation therapy and intralesional chemotherapy), and should be taken into account when evaluating the risk/benefit ratio of a treatment …”

Pharmacokinetics of platinum and safety evaluation of carboplatin‐impregnated calcium sulfate hemihydrate beads after implantation in healthy cats

“…In response to the challenges associated with locally invasive tumors, sustained‐release chemotherapeutic delivery systems have been developed to enhance regional control . Platinum‐based sustained‐release delivery substrates have been investigated for treatment of canine appendicular osteosarcoma, nasal tumors, and soft tissue sarcomas . However, these treatment compounds are not commercially available and result in local toxicosis.…”

In vitro chemosensitivity of feline injection site‐associated sarcoma cell lines to carboplatin

“…Results from these studies provided estimations of the minimum and maximum platinum concentrations expected to elute from CI‐CSH beads in vivo . Calcium sulfate hemihydrate is a proven biodegradable carrier for drug release and causes minimal reaction in tissues . However, before CI‐CSH beads can be recommended for use in tumor‐bearing cats, the efficacy of CI‐CSH beads against FISAS cells, and the safety and efficacy of CI‐CSH beads in cats must be determined.…”