Use of stereotactic body radiation therapy for treatment of a pancreatic tumor in a cat

Alba L. Gaitan-Cobo From the College of Veterinary Medicine and Biological Sciences, Colorado State University, Ft Collins, CO 80523 (Gaitan-Cobo) and Department of Radiological Health Sciences (Griffin, Kruckman-Gatesy), College of Veterinary Medicine and Biological Sciences, Colorado State University, Ft Collins, CO 80523. Alba Gaitan-Cobo was a fourth-year veterinary student at the time the report was submitted.

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Lynn R. Griffin From the College of Veterinary Medicine and Biological Sciences, Colorado State University, Ft Collins, CO 80523 (Gaitan-Cobo) and Department of Radiological Health Sciences (Griffin, Kruckman-Gatesy), College of Veterinary Medicine and Biological Sciences, Colorado State University, Ft Collins, CO 80523. Alba Gaitan-Cobo was a fourth-year veterinary student at the time the report was submitted.

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Carolynne R. Kruckman-Gatesy From the College of Veterinary Medicine and Biological Sciences, Colorado State University, Ft Collins, CO 80523 (Gaitan-Cobo) and Department of Radiological Health Sciences (Griffin, Kruckman-Gatesy), College of Veterinary Medicine and Biological Sciences, Colorado State University, Ft Collins, CO 80523. Alba Gaitan-Cobo was a fourth-year veterinary student at the time the report was submitted.

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Abstract

CASE DESCRIPTION

A 16-year old castrated male domestic shorthair cat was evaluated at a veterinary teaching hospital because of polyuria, polydipsia, and weight loss of 2 months’ duration.

CLINICAL FINDINGS

Hematologic and biochemical examination results were within respective reference ranges except for moderately high pancreas-specific lipase concentration. Ultrasonographic and cytologic evaluation revealed a hepatic mass with findings consistent with mild cholestasis and inflammation and a pancreatic mass that was initially identified as a neuroendocrine tumor.

TREATMENT AND OUTCOME

The cat underwent additional CT assessment and stereotactic body radiation therapy (SBRT; 3 fractions of 8 Gy, administered every other day) for treatment of the pancreatic tumor. Follow-up ultrasonographic and CT examinations indicated a partial response to SBRT, with a maximum CT-measured size reduction from 3.6 × 4.8 × 4.0 cm at the time of treatment planning to 2.0 × 2.0 × 1.9 cm 8 months later. Increased pancreatic tumor size and signs of carcinomatosis were detected 15 months after SBRT treatment; the initial cytologic diagnosis was changed to exocrine pancreatic carcinoma on reevaluation of the slides by another veterinary pathologist. Carboplatin treatment was elected, and signs of carcinomatosis resolved. The cat was euthanized without further testing because of weakness 589 days after SBRT was started.

CLINICAL RELEVANCE

To the authors’ knowledge, this is the first report of SBRT for suspected exocrine pancreatic carcinoma in a cat. Further investigation is needed to determine optimal fractionation schedules for SBRT of pancreatic tumors and utility of SBRT of exocrine pancreatic carcinoma in cats. (J Am Vet Med Assoc 2021;259:184–189)

Abstract

CASE DESCRIPTION

A 16-year old castrated male domestic shorthair cat was evaluated at a veterinary teaching hospital because of polyuria, polydipsia, and weight loss of 2 months’ duration.

CLINICAL FINDINGS

Hematologic and biochemical examination results were within respective reference ranges except for moderately high pancreas-specific lipase concentration. Ultrasonographic and cytologic evaluation revealed a hepatic mass with findings consistent with mild cholestasis and inflammation and a pancreatic mass that was initially identified as a neuroendocrine tumor.

TREATMENT AND OUTCOME

The cat underwent additional CT assessment and stereotactic body radiation therapy (SBRT; 3 fractions of 8 Gy, administered every other day) for treatment of the pancreatic tumor. Follow-up ultrasonographic and CT examinations indicated a partial response to SBRT, with a maximum CT-measured size reduction from 3.6 × 4.8 × 4.0 cm at the time of treatment planning to 2.0 × 2.0 × 1.9 cm 8 months later. Increased pancreatic tumor size and signs of carcinomatosis were detected 15 months after SBRT treatment; the initial cytologic diagnosis was changed to exocrine pancreatic carcinoma on reevaluation of the slides by another veterinary pathologist. Carboplatin treatment was elected, and signs of carcinomatosis resolved. The cat was euthanized without further testing because of weakness 589 days after SBRT was started.

CLINICAL RELEVANCE

To the authors’ knowledge, this is the first report of SBRT for suspected exocrine pancreatic carcinoma in a cat. Further investigation is needed to determine optimal fractionation schedules for SBRT of pancreatic tumors and utility of SBRT of exocrine pancreatic carcinoma in cats. (J Am Vet Med Assoc 2021;259:184–189)

Supplementary Materials

    • Supplementary Figure S1 (PDF 353 KB)
    • Supplementary Figure S2 (PDF 335 KB)
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