Use of imaging-guided intensity-modulated stereotactic body radiation therapy to treat a well-differentiated hepatocellular carcinoma in a dog

Abstract

CASE DESCRIPTION A 14-year-old 5.6-kg (12.3-lb) castrated male Toy Poodle was evaluated because of high serum activities of alkaline phosphatase and alanine amino-transferase and the presence of a hepatic mass. CLINICAL FINDINGS Abdominal CT revealed a large (approx 6.8 X 7.1 X 6.5-cm) soft tissue mass along the midline of the liver. The mass either originated from the papillary process of the caudate lobe or the left medial liver lobe. TREATMENT AND OUTCOME A partial liver lobectomy was performed, and approximately a third of the mass was successfully removed and submitted for histologic examination. Consultation with the oncology service was advised to determine whether radiation therapy could be used to treat the residual disease. On 5 consecutive days, the dog underwent imaging-guided intensity-modulated radiotherapy-stereotactic body radiation therapy (4 Gy/treatment) with a simultaneous integrated boost to the center of the tumor. The dog received a base dose of 20 Gy that was then boosted to 28 Gy. In the 10-month period after completion of radiation therapy, the hepatocellular mass continued to decrease in size, and overall improvements in the dog's serum liver enzyme abnormalities were evident. CLINICAL RELEVANCE There are few treatment options for dogs with incompletely excised hepatocellular carcinomas. On the basis of the positive outcome in this case, radiation therapy could be useful following incomplete surgical removal of hepatocellular carcinomas in dogs. (J Am Vet Med Assoc 2021;259:392–395)

Long‐term survival of a cat diagnosed with primary hepatic neuroendocrine carcinoma treated with surgical resection and several adjuvant chemotherapies

“…10 In addition, recent literature has supported the use of radiation therapy in successful management of incomplete surgical removal of hepatocellular carcinoma in a dog. 11 Therefore, additional local therapy such as radiation therapy may be of benefit in managing PHNEC in cats.…”

Diagnosa ultrasonografi hepatocellular carcinoma pada anjing

“…Vilkovyskiy et al (2020) menemukan bahwa 31% dari jenis tumor hati yang terjadi pada anjing merupakan jenis tumor HCC dan biasanya terjadi pada anjing yang berusia antara 9-13 tahun. Tumor HCC ini dibedakan berdasarkan bentuk dan penyebarannya dibagi menjadi: massive (terdiri dari satu tumor berukuran besar di hati), nodular (terdiri dari massa tumor dengan lokus atau nodul yang tersebar dalam jumlah dan ukuran bervariasi di hati), dan diffuse (penyebaran tumor sudah menyatu dengan jaringan parenkim hati sehingga tidak dapat dibedakan batasan antara parenkim dengan tumor) (Yang et al 2021).…”

Canine primary liver tumors treated with stereotactic body radiation therapy: A case series

“…6 The feasibility of other locoregional treatment modalities for human HCCs has been sporadically investigated in dogs. 3,7,8 The median survival time of conservatively managed HCC dogs is 270 days. 5 employed the theory that liver parenchyma functions as parallel functional subunits, and hence, high radiation doses can be delivered to the part of the liver provided that sufficient liver volume is preserved to optimize compensatory liver function.…”

“…19 Median survival time was 567 days. 19 Case reports 7,20 described promising outcomes of intensity-modulated radiation therapy (IMRT) used as sole or adjuvant treatment in two HCC dogs. Whilst radiation planning and delivery has advanced from 3D-CRT to IMRT and subsequently to volumetric-modulated arc therapy (VMAT) with improved precision and conformity, 21,22 and there are more reports on SBRT application in dogs; [23][24][25][26] based on a literature review, there has been no publication on VMAT delivery of SBRT to HCC dogs.…”

“…However, dogs with significant comorbidities, right‐sided liver tumors encircling caudal vena cava or portal vein, or large hilar tumors are poor surgical candidates 6 . The feasibility of other locoregional treatment modalities for human HCCs has been sporadically investigated in dogs 3,7,8 . The median survival time of conservatively managed HCC dogs is 270 days 5 …”