Referral

A 13-year-old DSH female cat referred for radiation therapy to actinic nasal plane squamous cell carcinoma (SCC).

Patient History

Patient presented to family vet for a small red ulcerative lesion in January 2018. An excisional biopsy involving partial nosectomy was performed on 9th February 2018 and histopathology confirmed actinic SCC (incomplete margins). On 2nd March 2018 the patient presented to family vet for recurrent disease at the surgical site. Due to the extent of the disease repeat surgery was not recommended and the patient was referred to the oncology team.

Diagnostics

Staging diagnostics included thoracic radiographs and cytology of the regional lymph nodes and were negative for metastatic disease. CT simulation for stereotactic radiation therapy was done on 21st March 2018.

Outcome

The patient tolerated the treatment very well with mild dry desquamation and hair loss noted in the treatment field. The tumour volume had reduced significantly 1 week later and was in clinical remission 6 weeks post therapy. The defect in the nasal tissues seen in the images is a result of the previous nosectomy surgery. The patient passed away 3 years and nine months after treatment from an unrelated illness.

Stereotactic radiation therapy (SRT) 3 day course of treatment to the nasal plane

SRT was prescribed to the nasal plane as a non- surgical alternative. Treatment was delivered via volumetric arc therapy (VMAT)

27Gy in 3 fractions to the Target volume

VMAT fields are used to provide excellent treatment. preserving healthy tissue and critical surrounding structures.

Daily Cone Beam CT was used to verify the accuracy and precision of treatment.

15 minute treatment time including daily image guided radiation therapy (IGRT).