- Title
- Brachytherapy treatment for equine ocular and/or periocular squamous cell carcinoma
- Creator
- Surjan, Yolanda
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2016
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Squamous Cell Carcinoma (SCC) is the most common tumour of the eye and adnexa in horses representing up to 75% of tumours. The management of equine ocular squamous cell carcinoma (OSCC) and/or periocular squamous cell carcinoma (POSCC) remains a challenge despite its high prevalence among horses. Literature suggests a number of treatment modalities currently exist; surgery, photodynamic therapy, cryotherapy, carbon dioxide (CO₂) laser ablation, radiofrequency hyperthermia, topical or intratumoral chemotherapy, and radiation therapy (RT), predominantly in the form of brachytherapy (implantation of sealed radioactive sources). Whilst no technique can conclusively be identified as the best approach to the treatment of OSCC/POSCC, successful treatment commonly involves one of the above therapies combined with cytoreductive surgery. Furthermore, the value of combining radiation therapy with surgery or using radiation therapy alone has been identified in relation to benefits in decreasing cosmetic and functional defects. The research presented in this thesis originated following an initial anecdotal source of enquiry suggesting a standardised treatment technique for OSCCC/POSCC in horses was non-existent. Simultaneously, a request from a veterinary practitioner for RT expertise input into the development of future RT protocols in veterinary medicine reinforced the value in conducting the research enquiry. The thesis presents a series of five studies demonstrating transition from the initial anecdotal source to the development of a Treatment Protocol. The interconnected research studies include; three literature reviews, a retrospective study (treatment modelling) and two surveys and concludes with the development of a Treatment Protocol and a supporting summary of the Code of Practice for Radiation Protection in Veterinary Medicine in the form of a flow-chart. The literature reviews identified the need for radiation therapy/radiation oncology expertise in the field of veterinary oncology and upon investigation of current and past treatment options nationally and internationally, concluded that a consistently favoured treatment option for OSCC/POSCC does not currently exist. An invited review was published in the Australian Equine Veterinarian Journal to coincide with the launch of the 2015 national survey. The retrospective study was performed on data collected from medical records from an Australian Equine Clinic. Retrospective treatment modelling was conducted on 75 horse cases treated with brachytherapy implants with radioactive Gold-198 wire between 1999 and 2007. All cases were replicated using Varian BrachyVisionTM radiation therapy treatment planning software. Results demonstrated treatments delivered between 1999-2007 were improved in most cases with the advantage of computerised optimisation. However, further analysis of previous treatments demonstrated a lack of consistency in reporting, radiation safety compliance and the absence of a standardised formal protocol. Surveys conducted with Australian veterinarians explored current and past treatment options for OSCC/POSCC and assessed knowledge and general compliance with radiation safety protection principles and treatment protocol use. This research identified standardised treatment protocols for OSCC/POSCC are clearly non-existent, and that radiation safety compliance and practice is deficient. In response to the findings of the retrospective modelling and the national surveys, a standardised Treatment Protocol in the form of a process flow-chart and a summarised version (visual-aid) of the Code of Practice for Radiation Protection in Veterinary Medicine were developed. The implementation of these resources will help translate an evidence based treatment approach using brachytherapy to a common neoplasm as well as minimise any unnecessary occupational irradiation.
- Subject
- brachytherapy; equine; oncology; squamous cell carcinoma
- Identifier
- http://hdl.handle.net/1959.13/1312236
- Identifier
- uon:22359
- Rights
- Copyright 2016 Yolanda Surjan
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Abstract | 1 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 20 MB | Adobe Acrobat PDF | View Details Download |