Use of three-dimensional conformal radiation therapy for treatment of a heart base chemodectoma in a dog.

Abstract

CASE DESCRIPTION: A 9-year-old spayed female mixed-breed dog was evaluated because of a progressively worsening, nonproductive cough and gagging of 1 year's duration. CLINICAL FINDINGS: Physical examination results were unremarkable. A cranial mediastinal mass was identified at the heart base with 3-view thoracic radiography. A CT scan of the thorax revealed an invasive mass surrounding major vessels at the heart base that was not considered surgically resectable. Thoracoscopic biopsy specimens of the cranial mediastinal mass were obtained, and histologic evaluation revealed that the tumor was a chemodectoma. TREATMENT AND OUTCOME: On the basis of results of the CT scan, a 3-D conformal radiation therapy plan was generated with computer treatment-planning software. The patient was treated with external beam radiation therapy; a 6-MV linear accelerator was used to deliver a prescribed dose of 57.5 Gy in twenty-three 2.5-Gy fractions. The cough improved following radiation therapy. Prior to treatment, the tumor volume was calculated to be 126.69 cm(3). Twenty-five months following radiation therapy, a follow-up CT scan was performed and there was a >50% reduction in tumor volume at that time. Disease progression causing pericardial, pleural, and peritoneal effusion and syncopal episodes occurred 32 months following radiation therapy, which were treated with pericardectomy and additional radiation therapy. The dog was still alive and doing well 42 months following initial radiation treatment. CLINICAL RELEVANCE: Conformal radiation therapy provided an additional treatment option for a nonresectable heart base chemodectoma in the dog of this report; conformal radiation therapy was reasonably tolerable and safe.