Survival times in dogs with presumptive intracranial gliomas treated with oral lomustine: A comparative retrospective study (2008‐2017)

Abstract

Intracranial gliomas are a common malignancy in dogs, and are associated with a poor prognosis due to their aggressive nature and a lack of clinically effective treatments. The efficacies of various treatment modalities for canine brain tumours have been previously described, though little data exist on the use of cytotoxic chemotherapy. A comparative retrospective study, including 40 cases from 5 northeastern US veterinary hospitals, from 2008 to 2017, was conducted. Variables analysed in this study with relation to overall survival and prognostic significance included: age, sex, clinical signs, clinical sign duration, tumour location and treatment protocol used. Dogs with presumptive intracranial gliomas treated with lomustine chemotherapy lived longer (median, 138 days) than those treated exclusively with symptomatic care (median, 35 days; P = .0026 log-rank, 0.0138 Wilcoxon). Additionally, a duration of clinical signs ≥16 days prior to diagnosis (median, 109 days) was associated with a longer survival than a duration <16 days prior (median, 25 days; P = .0100 log-rank, 0.0322 Wilcoxon). Lomustine-associated side effects included neutropenia in 46% of dogs, anaemia in 15% and thrombocytopenia in 15%. Potential renal and hepatotoxicity based on increased BUN and/or creatinine and ALT values were reported in 15% and 50% of dogs, respectively. This study provides evidence that lomustine therapy may be effective in prolonging survival in dogs with intracranial gliomas and should be considered as a potential treatment option. Although lomustine-related toxicities are fairly common, they are rarely life threatening and often do not result in discontinuation of therapy.

Definitive-intent uniform megavoltage fractioned radiotherapy protocol for presumed canine intracranial gliomas: retrospective analysis of survival and prognostic factors in 38 cases (2013–2019)

“…In symptomatic protocols (corticosteroids and anticonvulsants) MST doesn’t exceed 3.5 months (35–94 days) [ 10 , 21 – 23 ] and surgery doesn’t offer a significant gain in terms of survival [ 24 ] compared to symptomatic treatment protocols. Although chemotherapy is often an essential part of the therapy for human patients with intracranial gliomas [ 25 ], its benefits remain unclear in veterinary medicine [ 10 , 21 , 22 ]. A recent meta-analysis concerning brain tumour treatment [ 26 ], reported a median overall survival time of 226 days for RT-treated intra-axial tumours (range median of 60 to 437 days), based on 127 dogs.…”

Definitive-intent uniform megavoltage fractioned radiotherapy protocol for presumed canine intracranial gliomas: retrospective analysis of survival and prognostic factors in 38 cases (2013-2019).

“…In symptomatic protocols (corticosteroids and anticonvulsants) MST doesn't exceed 3.5 months (35-94 days) [10,[37][38][39] and surgery doesn't offer a signi cant gain in terms of survival [40]comparedto symptomatic treatment protocols. Although chemotherapy is often an essential part of the therapy for human patients with intracranial gliomas [41], its bene ts remain unclear in veterinary medicine [10,37,38]. A recent meta-analysis concerning brain tumour treatment [42], reported a median overall survival time of 226 days for RT-treated intra-axial tumours (range median of 60 to 437 days), based on 127 dogs.…”

Efficacy of frameless stereotactic radiotherapy for the treatment of presumptive canine intracranial gliomas: A retrospective analysis (2014‐2017)

“…1,4 Various modalities for the treatment of glial tumours have been described, including surgery, chemotherapy and radiotherapy (RT), with varying efficacies. 1, [5][6][7][8][9][10][11] Owing to the tendency of these tumours to infiltrate and subvert surrounding tissue, surgery is often difficult and not commonly attempted. 1, [4][5][6][7][8] Certain cytotoxic chemotherapeutic agents, most notably lomustine and temozolomide, have shown mild efficacy in prolonging survival in dogs with glial neoplasms, either as sole agents or as combination therapies.…”