Resumo
Mammary neoplasia represents the most frequently diagnosed type of neoplasia in bitches. Although surgical removal is the procedure of choice for therapeutic management, chemotherapy protocols appear as important allies and adjuvants. Despite the great advances that have occurred in the field of cancer therapy, the systemic repercussions of these drugs still impose important limitations on their use. In this sense, the development of increasingly targeted therapeutic protocols and preventive monitoring of patients represent important strategies to avoid possible complications - among them, Acute Kidney Injury (AKI). Routinely, ultrasound evaluation is used to identify morphological or metastatic variations in abdominal cavity organs. Acting complementary to the B-mode evaluation, Doppler mapping proves to be efficient in recognizing alterations in vascular hemodynamics. Therefore, the objective of the present study was to evaluate the use of B-mode and Doppler ultrasound to identify renal morphological and hemodynamic alterations in bitches with mammary neoplasia submitted to adjuvant chemotherapy protocols that associate gemcitabine with carboplatin. Thirteen bitches were included, without distinction of breed and between seven and 13 years of age. The animals were evaluated ultrasonographically at two different times during three consecutive chemotherapy cycles: before (T0) and one and a half hours after each cycle (T1), for 42 days. No morphological changes were observed in B-mode throughout the chemotherapy protocol. However, the Doppler velocimetry indices demonstrated statistical differences before (T0) and after (T1) the administration of the drugs. It was concluded that Doppler ultrasound could be used as a complementary method for monitoring the renal response of patients exposed to nephrotoxic drugs and potentially causing renal injury.
As neoplasias mamárias representam o tipo de neoplasma mais frequentemente diagnosticado em fêmeas da espécie canina. Embora a remoção cirúrgica seja o procedimento de eleição para a conduta terapêutica, os protocolos quimioterápicos aparecem como importantes aliados e adjuvantes. Apesar dos grandes avanços ocorridos na área da terapia oncológica, as repercussões sistêmicas destes fármacos ainda impõem importantes limitações ao seu uso. Neste sentido, o desenvolvimento de protocolos terapêuticos cada vez mais direcionados e o monitoramento preventivo dos pacientes representam estratégias importantes para evitar possíveis complicações - dentre elas, a injúria renal aguda (IRA). Rotineiramente, a avaliação ultrassonográfica é utilizada para identificação de variações morfológicas ou metastáticas em órgãos da cavidade abdominal. Atuando de forma complementar à avaliação em modo-B, o mapeamento Doppler mostra-se eficiente no reconhecimento de alterações na hemodinâmica vascular. Portanto, o objetivo do presente estudo foi avaliar a utilização da ultrassonografia modo-B e Doppler como método para identificação de alterações morfológicas e hemodinâmicas renais em cadelas com neoplasias mamárias submetidas a protocolos quimioterápicos adjuvantes que associam a gencitabina à carboplatina. Foram incluídas 13 fêmeas caninas, sem distinção quanto a raça e com idades entre sete e 13 anos. Os animais foram avaliados ultrassonograficamente em dois momentos distintos durante três ciclos quimioterápicos consecutivos: antes (T0) e uma hora e meia após a realização de cada ciclo (T1), totalizando 42 dias. Não foram observadas alterações morfológicas em modo-B ao longo do protocolo quimioterápico. Entretanto, os índices dopplervelocimétricos demonstraram diferenças estatísticas antes (T0) e após (T1) a administração dos fármacos. Concluiu-se que a ultrassonografia Doppler pode ser utilizada como método complementar para o monitoramento da resposta renal de pacientes expostos a fármacos nefrotóxicos e potencialmente causadores de injúrias renais.
Assuntos
Animais , Feminino , Cães , Neoplasias Mamárias Animais/complicações , Quimioterapia Adjuvante/efeitos adversos , Quimioterapia Adjuvante/veterinária , Doenças do Cão , Injúria Renal Aguda/veterinária , Injúria Renal Aguda/diagnóstico por imagem , Carboplatina , Ultrassonografia Doppler/veterinária , GencitabinaResumo
Background: The proliferative disorders of mast cells include, in addition to mast cell tumor, systemic mastocytosis and myeloid leukemia of mast cells. Surgery is the treatment of choice for tumors in the skin, in regions which allow wide excision but adjuvant treatments should be performed in selected patients. However, the use of adjuvant chemotherapy remains empirical, due to the absence of controlled studies. Despite the relevance of the use of tyrosine kinase inhibitors for the treatment of mast cell tumors, studies with these drugs have focused primarily on neoadjuvant scenery. Case: A 13-year-old male Poodle dog, weighing 4.6 kg, was presented with bilateral increase in inguinal lymph nodes and a vesicular cutaneous lesion, in the inguinal region, 75 days after surgery for the removal of a scrotum grade II mast cell tumor. Patient was admitted for surgery and the tissues removed were sent for pathological examination that allowed the diagnosis of grade II mast cell tumor and metastasis in all inguinal lymph nodes. The immunohistochemical study for CD117 revealed an aberrant expression of KIT receptor (KIT II), while the PCR for mutations in exon 11 of c-KIT gene revealed internal tandem duplications. The patient underwent a session of chemotherapy with lomustine, however it had serious side effects that resulted in discontinuation of treatment, opting for utilization...(AU)
Assuntos
Animais , Masculino , Cães , Mesilato de Imatinib/administração & dosagem , Mesilato de Imatinib/uso terapêutico , Mastocitoma/terapia , Mastocitoma/veterinária , Proteínas Tirosina Quinases , Quimioterapia Adjuvante/veterináriaResumo
Background: The proliferative disorders of mast cells include, in addition to mast cell tumor, systemic mastocytosis and myeloid leukemia of mast cells. Surgery is the treatment of choice for tumors in the skin, in regions which allow wide excision but adjuvant treatments should be performed in selected patients. However, the use of adjuvant chemotherapy remains empirical, due to the absence of controlled studies. Despite the relevance of the use of tyrosine kinase inhibitors for the treatment of mast cell tumors, studies with these drugs have focused primarily on neoadjuvant scenery. Case: A 13-year-old male Poodle dog, weighing 4.6 kg, was presented with bilateral increase in inguinal lymph nodes and a vesicular cutaneous lesion, in the inguinal region, 75 days after surgery for the removal of a scrotum grade II mast cell tumor. Patient was admitted for surgery and the tissues removed were sent for pathological examination that allowed the diagnosis of grade II mast cell tumor and metastasis in all inguinal lymph nodes. The immunohistochemical study for CD117 revealed an aberrant expression of KIT receptor (KIT II), while the PCR for mutations in exon 11 of c-KIT gene revealed internal tandem duplications. The patient underwent a session of chemotherapy with lomustine, however it had serious side effects that resulted in discontinuation of treatment, opting for utilization...