title: ASSOCIATION BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS AND FRACTURES FOLLOWING STEREOTACTIC RADIOSURGERY IN DOGS WITH APPENDICULAR OSTEOSARCOMA.
abstract: The objective of this observational, descriptive, retrospective study was to report CT characteristics associated with fractures following stereotactic radiosurgery in canine patients with appendicular osteosarcoma. Medical records (1999 and 2012) of dogs that had a diagnosis of appendicular osteosarcoma and undergone stereotactic radiosurgery were reviewed. Dogs were included in the study if they had undergone stereotactic radiosurgery for an aggressive bone lesion with follow-up information regarding fracture status, toxicity, and date and cause of death. Computed tomography details, staging, chemotherapy, toxicity, fracture status and survival data were recorded. Overall median survival time (MST) and fracture rates of treated dogs were calculated. CT characteristics were evaluated for association with time to fracture. Forty-six dogs met inclusion criteria. The median overall survival time was 9.7 months (95% CI: 6.9-14.3 months). The fracture-free rates at 3, 6, and 9 months were 73%, 44%, and 38% (95% CI: 60-86%, 29-60%, and 22-54%), respectively. The region of bone affected was significantly associated with time to fracture. The median time to fracture was 4.2 months in dogs with subchondral bone involvement and 16.3 months in dogs without subchondral bone involvement (P-value = 0.027, log-rank test). Acute and late skin effects were present in 58% and 16% of patients, respectively. Findings demonstrated a need for improved patient selection for this procedure, which can be aided by CT-based prognostic factors to predict the likelihood of fracture.
authors.affiliation: Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.|Angell Animal Medical Center, Jamaica Plain, MA, Boston, MA, 02130.
authors.forename: Lyndsay
authors.initials: L
authors.lastname: Kubicek
authors.affiliation: Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.
authors.forename: Daniel
authors.initials: D
authors.lastname: Vanderhart
authors.affiliation: Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Wirth
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, FL, 32611.
authors.forename: Qi
authors.initials: Q
authors.lastname: An
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, FL, 32611.
authors.forename: Myron
authors.initials: M
authors.lastname: Chang
authors.affiliation: Pet Emergency and Specialty Center of Marin, San Rafael, CA, 94901.
authors.forename: James
authors.initials: J
authors.lastname: Farese
authors.affiliation: Department of Neurosurgery, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611.
authors.forename: Francis
authors.initials: F
authors.lastname: Bova
authors.affiliation: the Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 94143.
authors.forename: Atchar
authors.initials: A
authors.lastname: Sudhyadhom
authors.affiliation: Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Kow
authors.affiliation: Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Bacon
authors.affiliation: Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, 32611.
authors.forename: Rowan
authors.initials: R
authors.lastname: Milner
mesh_terms: D000818:Animals; D001063:Appendiceal Neoplasms / Q000150:complications / Q000662:veterinary*; D001859:Bone Neoplasms / Q000150:complications / Q000662:veterinary*; D004283:Dog Diseases / Q000209:etiology* / Q000601:surgery*; D004285:Dogs; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000662:veterinary*; D008297:Male; D012516:Osteosarcoma / Q000150:complications / Q000662:veterinary*; D016634:Radiosurgery / Q000009:adverse effects / Q000662:veterinary*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000662:veterinary
keywords: canine bone tumor; fracture; osteosarcoma; stereotactic radiation; stereotactic radiosurgery