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Pilot study to determine the feasibility of radiation therapy for dogs with right atrial masses and hemorrhagic pericardial effusion
Authors:MW Nolan  MM Arkans  D LaVine  T DeFrancesco  JA Myers  EH Griffith  LP Posner  BW Keene  SP Tou  TL Gieger
Institution:1. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA;2. Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA;3. Department of Statistics, North Carolina State University, Raleigh, NC, 27675, USA;4. Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA;5. Triangle Veterinary Referral Hospital, 608 Morreene Road, Durham, NC, 27705, USA;6. MedVet Chicago, 3130 N. Clybourn Ave., Chicago, IL, 60618, USA
Abstract:

Objectives

To determine the short-term safety and biologic activity of radiation therapy (RT) for presumptive cardiac hemangiosarcoma in pet dogs.

Animals

Six dogs with echocardiographic evidence of a right atrial/auricular mass, and hemorrhagic pericardial effusion, were enrolled in a prospective, single-arm clinical trial.

Methods

A single fraction of 12 Gy was delivered using conformal external beam irradiation. Serum cardiac troponin I and plasma concentrations of vascular endothelial growth factor were quantified before, 4 and 24 h after RT. The frequency of required pericardiocenteses (quantified as the number of pericardiocenteses per week) before RT was compared to that after treatment. Overall survival time was determined.

Results

No treatment-related complications were observed. Pericardiocentesis was performed an average of 0.91 times per week before RT, and an average of 0.21 times per week after RT; this difference was statistically significant (p=0.03, as compared using a Wilcoxon signed-rank test of paired data). Pre- and post-treatment plasma vascular endothelial growth factor concentrations were not significantly different at any time point; there was a statistically significant (p=0.04; Friedman's test for non-parametric repeated measures) increase in cardiac troponin concentrations 4 h after irradiation. Median overall survival time was 79 days.

Conclusions

In this population of dogs, RT was delivered without complication, and appears to have reduced the frequency of periacardial tamponade that necessitated pericardiocentesis. Serum cardiac troponin levels are altered after RT. RT alone, or in combination with chemotherapy, may provide clinical benefit to dogs with presumptive diagnoses of cardiac hemangiosarcoma.
Keywords:Heart-base tumor  Cardiac hemangiosarcoma  Canine
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