Leczenie raka płaskonabłonkowego

Squamous cell cancer (SCC) (Carcinoma planoepitheliale) is the most frequent malignant neoplasm of the oral cavity in dogs and cats. It typically occurs in animals 8-10 years old, medium-sized and large breeds, with both sexes prone to the diseases to the same extent. Macroscopically, it is an irregular growth, and proliferative or ulcerated lesion; the neoplastic tissue is frail and bleeds. It is rarely metastatic; therefore, the topical tumour growth is to be controlled. The procedure of choice is a surgical treatment. However, radiotherapy is used in advanced cancer or in inoperable tumours.

Squamous cell cancer (SCC) (Carcinoma planoepitheliale) is the most frequent malignant neoplasm of the oral cavity in dogs and cats. It typically occurs in animals 8-10 years old, medium-sized and large breeds, with both sexes prone to the diseases to the same extent. Macroscopically, it is an irregular growth, and proliferative or ulcerated lesion; the neoplastic tissue is frail and bleeds. It is rarely metastatic; therefore, the topical tumour growth is to be controlled. The procedure of choice is a surgical treatment. However, radiotherapy is used in advanced cancer or in inoperable tumours.

Case report

Patient’s details:

  • Animal’s name: BASTER
  • Species: dog
  • Breed: Labrador Retriever
  • Sex: male
  • Age: 9 years old
  • Colour: cream
  • Weight: 37 kg
  • Not castrated

Medical history:

May 2013: Clinically noticed lesion in the body of the mandible (left side) infiltrating the mandibular symphysis. X-ray of the lesion (Fig. 1) and plain chest X-ray were done (Fig. 2).

Pysk psaFig. 1

Ryc.2.

Fig. 2

The biochemical analysis of the blood sample was performed: ALP 1,560 U/L; AlaT 45 U/L; AspAT 34 U/L; urea 30 mg/dL; creatinine 1.0 mg/dL.

A specimen was taken for histopathological examinations. The tissue sample was taken from the deep layers of the proliferative lesion, the vestibule of the mouth from the area of the right bottom I2. The examination was carried out at the Histopathological Laboratory of the Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Life Sciences in Lublin.

Rak płaskonabłonkowy u psaFig. 3: Initial condition

Diagnosi:

Acantholytic squamous cell cancer (Carcinoma Planoepitheliale Acantholiticum) (Fig. 4)

rak płaskonabłonkowy akantolityczny Fig. 4: Acantholytic squamous cell cancer

Therapy:

Due to the location of the lesion and cancer type, the owner was proposed the bilateral mandibular reduction. Given its traumatism and related consequences, the owner did not agree to the procedure. The decision was taken to start an experimental palliative therapy with laser light, with wavelengths of 660 nm and 808 nm, using the ETIUS ULM multifunctional equipment made by ASTAR from Bielsko-Biała.

laserterapia psaFig. 5: Therapy

The therapy was divided into two phases:

1. Intensive irradiation phase

  • Radiation source type: I and IR
  • Power dose: 10 J/cm²
  • Irradiation area: 25 cm²
  • Irradiation power: max. (5×40 mW and 4×400 mW)
  • Impulse frequency: 1,000 Hz
  • Duty cycle at the impulse work: 50%
  • Energy of the procedure: 250.00 J
  • Method of the procedure: contactless, labile (from the outside)
  • Duration of the procedure: 4:37 min
  • Frequency of the procedure: daily
  • Duration: 3 weeks

2. Maintenance irradiation phase:

  • Radiation source type: I and IR
  • Power dose: 10 J/cm²
  • Irradiation area: 25 cm²
  • Irradiation power: max. (5×40 mW and 4×400 mW)
  • Impulse frequency: 1,000 Hz
  • Duty cycle at the impulse work: 50%
  • Energy of the procedure: 250.00 J
  • Method of the procedure: tactile (from the outside and inside)
  • Duration of the procedure: 4:37 min
  • Frequency of the procedure: every 3 days
  • Duration: 11 months

In the course of the therapy, the follow-up X-ray was done (Fig. 6; Fig. 7) and the biochemical analysis of the blood sample (ALP, AlaT, AspAT, urea, creatinine) was performed.

RTG podczas terapii1Fig. 6: X-ray during the therapy

RTG podczas terapii2

Fig. 7: X-ray during the therapy

Radiograms made in the course of the therapy (a visible change in the periosteal reaction and the reduction of the neoplastic lesion).

Change in the activity of alkaline phosphatase

Zmiany aktywności Fosfatazy zasadowej

Weeks of the study

 

Change in the activity of alanine transaminase AlaT

Zmiany aktywności aminotranserazy alaninowej ALaT

Weeks of the study

 


Change in the activity of AspAT

Zmiany aktywności AspAT

Weeks of the study

 


Change in the urea concentration

Zmiany stężenia mocznika

Weeks of the study

 

Change in the creatinine concentration

Zmiany stężenia kreatyniny

Weeks of the study

The therapy brought about:

  • Elimination of the muzzle inflammation
  • Inhibition of the neoplastic proliferation
  • Around 20% reduction of the original neoplastic lesion

Changes in general parameters:

Date/Parameter Eagerness to eat Pain on opening the muzzle
May 2013 + +++
December 2013 ++ ++
June 2014 +++ +
November 2014 ++++

 

Conclusions:

  • The application of laser light is not a cause-related therapy.
  • The therapy is not significantly influenced by the change in biochemical parameters, i.e. AlaT, AspAT, urea, creatinine.
  • The irradiation of the neoplastic lesion with laser light, with wavelengths of 660 nm and 808 nm, is a palliative procedure improving the comfort of suffering from the disease.
  • The results obtained during the therapy require further studies, causes of the reaction of cancer cells to the effect of laser light with wavelengths of 660 nm and 808 nm.

Pain on opening the muzzle Normal 0 21 false false false PL X-NONE X-NONE

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