PROCEDURE FOR THE PATIENT

The patients who need treatment both radiotherapy and a comprehensive approach to neoplastic disease are the part of our Center. Patients who require only the radiation treatment, undergoing anesthesia visit, access to the execution of an combined examination CT and MRI for the determination of staging and extention of the disease. On the basis of the 3D CT image fusion with the resonance a CT plan is set up through the means of virtual simulation which, sent to the accelerator, is essential to plan the treatment. This includes a number of different sessions depending on whether it is stereotactic radiosurgery, fractionated stereotactic radiotherapy, conventional fractionated radiotherapy, palliative radiotherapy oncology, non-oncological radiotherapy. Each treatment is carried out thanks to the synergy between veterinarians, physicians and radiotherapy consultants. During radiation treatment, the patient is controlled and monitored to detect possible side effects of toxicity and to put to use all necessary measures to counteract them. Usually the side effects of acute onset are of short duration and do not last for more than 2-3 weeks after the end of radiotherapy. At the end of radiation therapy are scheduled check-ups to evaluate the therapeutic response. Patients presented for a comprehensive therapeutic procedure for neoplastic disease undergo specialist visit in order to identify, in consultation with the attending veterinarian, the most appropriate treatment options (surgery, chemotherapy, radiotherapy).

The radiation treatment can be performed alone or in combination with other therapeutic methods such as surgery and / or chemotherapy.

Radiotherapy associating with surgery can be performed before, during or after operation. 

  • The treatment can be performed before surgery (neoadjuvant) in order to reduce the masses otherwise difficult to resect  (eg. mastocytoma in critical areas, thymoma).
  • At La Cittadina Fondazione Studi e Ricerche Veterinarie a bunker is connected to the surgical section. In this way can be conducted sessions of intra-operative radiotherapy. This method of treatment involves the selective delivery in single fraction of high-energy electrons directly into the surgical bed, often avoiding the need or limiting il post-surgical fractionated treatment (eg. soft tissue sarcomas, pelvic-perineal tumors, oral and nazal tumors).
  • The post-operative radiotherapy (adjuvant) provides expenditure in fractionated doses of treatment once the wound has healed (15-20 days after surgery) in order to sterilize the field from residual microscopic cancer (eg excision with non-free margins or high grade tumors). Obviously the received and treated patients are operated both at the center and at the referring veterinarian external structures.

Thanks to the presence of micro multileaf collimator, CT incorporated in the accelerator and the software that allows the precise identification of the target volume, the delivered dose can be given in fewer fractions than in conventional accelerators, and each session lasts no more than 2 minutes. All this is an advantage for the animal that can be treated in a simple short sedation or narcosis, with a lower number of sedation (1 in case of radiosurgery, 3 - 5 over 5 days in the case of fractionated stereotactic radiosurgery, 6-12 in the case of hypofractionated conventional radiotherapy). Treatment plans may provide more sessions (fractionated radiotherapy over 2-4 weeks). The precision in the treatment allows the significantly higher results than in conventional radiation therapy, what explains higher cure rate, less complications, the longer disease-free period and longer median survival.

 

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