Page 534 - Withrow and MacEwen's Small Animal Clinical Oncology, 6th Edition

512 PART IV Specific Malignancies in the Small Animal Patient

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A B

C D

• Fig. 24.15 (A) A lateral thoracotomy is being performed to allow for removal of a primary pulmonary
carcinoma. (B) The lung lobe containing the tumor (asterisk) has been exteriorized and a surgical stapler
is being positioned. (C) After placement of the surgical staples, the affected lung lobe is being transected
to allow for removal. (D) The staple line (black arrow) can be seen after removal of the tumor. The line of
resection is examined closely for leaks.

toceranib resulted in stable disease >10 weeks in one dog with a techniques. The use of such modalities in veterinary patients is
primary lung carcinoma. 358 Further research is warranted to deter- now becoming more accessible but remains to be systematically
mine the clinical efficacy of TKIs in the management of cats and investigated in dogs and cats with lung tumors.
dogs with primary lung tumors.
Malignant pleural effusions can be responsive to systemic che- Interventional Therapy
motherapy, intrapleural chemotherapy, or a combination of both
routes. Cisplatin, carboplatin, and mitoxantrone have been used Interventional oncologic techniques for the treatment of primary
successfully for this purpose, resulting in temporary palliation of pulmonary neoplasia have not been described in the veterinary lit-
clinical signs. 359–362 Sclerosing agents, such as talc or tetracyclines, erature; however, several treatment options exist in human medi-
have been also been used in a palliative setting. 363 cine for pulmonary neoplasia. 365–368 These options are generally
reserved for cases of pulmonary metastatic disease, nonresectable
Radiation Therapy pulmonary tumors, or patients for which surgery is contraindi-
cated due to existing comorbidities. 366–369 Research into this field
Radiation therapy in physician-based medicine is most often in veterinary patients is ongoing and some of these techniques are
reserved for locally advanced tumors. 364 Technologies such as currently being investigated.
intensity-modulated radiation therapy, stereotactic radiation Thermal ablation (radiofrequency and microwave) and regional
therapy, or TomoTherapy can now be used to provide more pre- chemotherapy administration are two interventional oncology
cise delivery of radiation while sparing unaffected tissues, espe- techniques that have been reported in the treatment of pulmonary
cially when used together with respiratory gating or breath hold neoplasia. Radiofrequency ablation (RFA) is performed by placing