@article{baja_kelsey_ruslander_gieger_nolan_2022, title={A retrospective study of 101 dogs with oral melanoma treated with a weekly or biweekly 6 Gy x 6 radiotherapy protocol}, volume={4}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12815}, abstractNote={One radiotherapy (RT) protocol used for canine oral melanoma (OM) gives 36 Gy total, in six weekly or biweekly fractions (6 Gy × 6). This retrospective study characterizes oncologic outcomes for a relatively large group of dogs treated with this protocol and determines whether radiation dose intensity (weekly vs. biweekly) affected either progression-free or overall survival (PFS and OS). Dogs were included if 6 Gy × 6 was used to treat grossly evident OM, or if RT was used postoperatively in the subclinical disease setting. Kaplan-Meier statistics and Cox regression modelling were used to determine the predictive or prognostic value of mitotic count, bony lysis, World Health Organization (WHO) stage (I, II, III, or IV), using systemic anti-cancer therapies, tumour burden at the time of RT (macroscopic vs. subclinical), radiation dose intensity (weekly vs. biweekly), and treatment planning type (manual vs. computerized). The median PFS and OS times for all dogs (n = 101) were 171 and 232 days, respectively. On univariate analysis PFS and OS were significantly longer (p = <.05) with subclinical tumour burden, WHO stages I or II, and weekly irradiation. On multivariable analysis, only tumour stage remained significant; therefore, cases were grouped by WHO stage (I/II vs. III/IV). With low WHO stage (I/II), PFS and OS were longer when irradiating subclinical disease (PFS: risk ratio = 0.449, p = .032; OS: risk ratio = 0.422, p = .022); this was not true for high WHO stage (III/IV). When accounting for other factors, radiation dose intensity had no measurable impact on survival in either staging group.}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Baja, Alexie J. and Kelsey, Krista L. and Ruslander, David M. and Gieger, Tracy L. and Nolan, Michael W.}, year={2022}, month={Apr} }
 @article{watson-skaggs_gieger_yoshikawa_nolan_2022, title={Endocrine response and outcome in 14 cats with insulin resistance and acromegaly treated with stereotactic radiosurgery (17 Gy)}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.21.08.0122}, abstractNote={To describe clinical outcomes in cats with insulin resistance and acromegaly treated with stereotactic radiosurgery (SRS).14 client-owned cats.Medical records of cats with insulin resistance and acromegaly treated with SRS (17 Gy) between August 2013 and November 2019 at a single institution were reviewed. Kaplan-Meier analysis was used to evaluate overall survival time.Acute adverse effects of SRS included somnolence (n = 2) and alopecia (1). Delayed adverse effects of SRS included unspecified neurologic complications (n = 1; 481 days), seizures (1; 1,541 days), and hypothyroidism (1; 64 days). Exogenous insulin requirements decreased in 10 of the 14 cats, with a median time to lowest insulin dose of 399 days (range, 42 to 879 days). Complete diabetic remission was achieved in 3 cats. The median overall survival time was 741 days (95% CI, 353 to 1,129 days). Six cats were still alive at the end of the study period, with a median follow-up time of 725 days. In 7 of the 8 cats that had died, death was presumptively attributed to acromegaly owing to continued insulin resistance, organ failure, or altered neurologic status.The SRS protocol was well tolerated and associated with survival times similar to those reported previously. Most cats had decreased exogenous insulin requirements after SRS. Latency to an endocrine response was highly variable, emphasizing the need for careful ongoing diabetic monitoring of acromegalic cats after pituitary gland irradiation.}, number={1}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Watson-Skaggs, Maegan L. and Gieger, Tracy L. and Yoshikawa, Hiroto and Nolan, Michael W.}, year={2022}, month={Jan}, pages={64–71} }
 @article{gieger_haney_nolan_2022, title={Re-irradiation of canine non-lymphomatous nasal tumours using stereotactic radiation therapy (10 Gy x 3) for both courses: Assessment of outcome and toxicity in 11 dogs}, volume={2}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12801}, abstractNote={Abstract No uniformly beneficial treatments exist for dogs with non‐lymphomatous nasal tumours (NLNT) that relapse after radiotherapy (RT). Reirradiation may prolong survival and improve quality of life. In this retrospective study, we describe outcomes for 11 dogs that had CT‐confirmed locoregional progression of NLNT after an initial course of stereotactic RT (SRT#1; 10 Gy × 3) and were then re‐treated with the same type of protocol (SRT#2, also 10 Gy × 3). The median time between SRT #1 and SRT #2 was 243 days (95% CI: 78–385 days). Ten dogs (91%) had a clinical benefit after SRT#1; five dogs (45%) had clinical benefit after SRT#2. Adverse events after SRT#2 included nasocutaneous or oronasal fistula formation ( N = 3 at 180, 270, and 468 days), seizures ( N = 2 at 78 and 330 days), bacterial or fungal rhinitis ( N = 2 at 240 and 385 days), and facial swelling ( N = 1 at 90 days). All 11 dogs have died, due to disease progression, presumed radiotoxicity, or declining quality of life; in most cases, it was difficult to discern between these conditions. The median overall survival time (OST) from SRT#1 was 745 days (95% CI: 360–1132). The median overall survival time (OST) from SRT #2 was 448 days (95% CI: 112–626). For these dogs, survival was prolonged, but adverse events after SRT#2 were common (8/11; 73%). Therefore, before consenting to re‐irradiation with this protocol, pet owners should be counselled about survivorship challenges, including risk for severe toxicities, and persistence of clinical signs.}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Gieger, Tracy L. and Haney, Siobhan M. and Nolan, Michael W.}, year={2022}, month={Feb} }
 @article{nolan_berman_watson-skaggs_quinn_marcus_russell_yoshikawa_olby_gieger_2022, title={Stereotactic radiotherapy (10 Gy X 3) for canine nonlymphomatous intranasal tumors is associated with prolonged survival and minimal risk of severe radiotoxicity}, volume={260}, ISSN={["1943-569X"]}, DOI={10.2460/javma.22.03.0141}, abstractNote={Abstract OBJECTIVE To describe oncologic outcomes following administration of a uniform stereotactic radiotherapy protocol (SRT; 10 Gy X 3) for canine intranasal tumors and to identify whether any clinical or dosimetric factors were predictive of event-free or overall survival time (EFST or OST). ANIMALS 129 dogs. PROCEDURES In this single-institution retrospective study, the medical records database was searched for canine nonlymphomatous intranasal tumors treated with 10 Gy X 3 SRT between August 2013 and November 2020. Findings regarding adverse effects and outcomes were analyzed overall, for dogs grouped on the basis of life stage (mature adult, senior, or end of life), and for treatment-related or tumor-related variables to identify potential predictors of outcome. RESULTS After SRT, most dogs clinically improved with minimal acute radiotoxicity. The median EFST was 237 days; median OST was 542 days. Receipt of other tumor-directed therapies before or after SRT was associated with improved EFST in senior dogs (hazard ratio [HR], 0.416) and improved OST in mature adult (HR, 0.241) and senior dogs (HR, 0.348). In senior dogs, administration of higher near-minimum radiation doses was associated with improved EFST (HR, 0.686) and OST (HR, 0.743). In senior dogs, chondrosarcoma was associated with shorter OST (HR, 7.232), and in dogs at end of life, having a squamous cell or transitional carcinoma was associated with worse EFST (HR, 6.462). CLINICAL RELEVANCE This SRT protocol results in improved quality of life and prolonged OST for dogs of all life stages. Radiation protocol optimization or use of multimodal therapy may further improve outcomes.}, number={12}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Nolan, Michael W. and Berman, Alyssa R. and Watson-Skaggs, Maegan L. and Quinn, Claire N. and Marcus, Karen L. and Russell, Katharine and Yoshikawa, Hiroto and Olby, Natasha J. and Gieger, Tracy L.}, year={2022}, month={Sep}, pages={1496–1506} }
 @article{yoshikawa_gieger_saba_fredrickson_kubicek_haney_ruslander_kelsey_mcentee_nolan_2021, title={Retrospective evaluation of intranasal carcinomas in cats treated with external-beam radiotherapy: 42 cases}, volume={35}, ISSN={["1939-1676"]}, DOI={10.1111/jvim.16098}, abstractNote={Abstract Background Little is known regarding the comparative efficacy of various irradiation strategies used to treat intranasal carcinomas (INC) in cats. Objectives Investigate outcomes and prognostic factors associated with survival for cats with INC. Animals Forty‐two cats with INC that underwent radiotherapy (RT). Methods Single‐arm retrospective study. Medical record review for cats with INC that underwent RT at 1 of 7 veterinary RT facilities. Irradiation protocols categorized as: definitive‐intent fractionated RT (FRT), definitive‐intent stereotactic RT (SRT), and palliative‐intent RT (PRT). Median overall survival time (OST) and disease progression‐free survival (PFS; documented by advanced transverse imaging, or recurrence of symptoms) were calculated. Associations between tumor stage, RT protocol/intent, and adjunctive treatment usage and outcome were calculated. Results Cats underwent SRT (N = 18), FRT (N = 8), and PRT (N = 16). In multivariate modeling, cats received definitive‐intent treatment (DRT; FRT/SRT) had significantly longer median PFS (504 days, [95% confidence interval (CI): 428–580 days] vs PRT 198 days [95% CI: 62–334 days]; p = 0.006) and median OST [721 days (95% CI: 527–915 days) vs 284 days (95% CI: 0–570 days); p = 0.001]). Cats that underwent second DRT course at time of recurrence lived significantly longer than cats that received 1 RT course (either DRT or PRT [median OST 824 days (95% CI: 237–1410 days) vs 434 days (95% CI: 277–591 days); p = .028]). Conclusion In cats with INC, DRT is associated with prolonged OST and PFS as compared to PRT. If tumor progression occurs, a second course of DRT should be considered.}, number={2}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Yoshikawa, Hiroto and Gieger, Tracy L. and Saba, Corey F. and Fredrickson, Kirsha and Kubicek, Lyndsay and Haney, Siobhan and Ruslander, David and Kelsey, Krista L. and McEntee, Margaret C. and Nolan, Michael W.}, year={2021}, month={Mar}, pages={1018–1030} }
 @article{gieger_seiler_nolan_2021, title={Treatment of feline gastrointestinal intermediate- or large-cell lymphoma with lomustine chemotherapy and 8 Gy abdominal cavity radiation therapy}, volume={23}, ISSN={["1532-2750"]}, DOI={10.1177/1098612X20959602}, abstractNote={Objectives The goal of this study was to document the outcomes and toxicity of a novel multimodality treatment protocol for feline gastrointestinal intermediate- or large-cell lymphoma (FGL) in which cats were treated at 21-day intervals. Methods This was a prospective, single-arm study. Twelve client-owned cats with cytologically diagnosed FGL were treated with a combination of abdominal cavity radiation therapy (RT; 8 Gy total dose administered in two 4 Gy fractions, 21 days apart), lomustine chemotherapy (approximately 40 mg/m 2 , administered orally at 21-day intervals for four treatments), prednisolone (5 mg PO q24h) and cobalamin (250 µg/week SC). Results Three cats were euthanized prior to the second treatment and it was difficult to discern treatment-associated toxicity from progressive disease. Four of the remaining cats developed cytopenias, resulting in 7–14-day lomustine treatment delays and/or dose reductions. Six cats had a partial response to treatment and three had stable disease based on ultrasound at day 21 (50% overall response rate). Three of these six cats completed the study and lived >240 days; one died of refractory diabetes mellitus with no clinical evidence of FGL, and the other two died as a result of FGL. The median overall survival time was 101 days (95% confidence interval [CI] 9–240). The median progression-free survival time was 77 days (95% CI 8–212). Necropsies were performed in eight cats, which revealed multifocal lymphoma throughout the gastrointestinal tract and other organs. Conclusions and relevance Oncological outcomes reported herein are comparable to those achieved with multiagent injectable chemotherapy (eg, CHOP). Treatment was seemingly well tolerated in most cats and was relatively cost-effective. It is therefore plausible that improved disease control may be achievable through continued optimization and intensification of the combinatorial chemoradiotherapy protocol.}, number={6}, journal={JOURNAL OF FELINE MEDICINE AND SURGERY}, author={Gieger, Tracy L. and Seiler, Gabriela S. and Nolan, Michael W.}, year={2021}, month={Jun}, pages={469–476} }
 @article{clerc-renaud_gieger_larue_nolan_2021, title={Treatment of genitourinary carcinoma in dogs using nonsteroidal anti-inflammatory drugs, mitoxantrone, and radiation therapy: A retrospective study}, volume={35}, ISSN={["1939-1676"]}, DOI={10.1111/jvim.16078}, abstractNote={Abstract Background Locoregional tumor control and prolonged survival for dogs with genitourinary carcinoma (CGUC) reportedly are achievable using treatment with radiotherapy (RT) with or without adjunctive chemotherapy and nonsteroidal anti‐inflammatory drugs (NSAIDs). Objectives To characterize event‐free and overall survival after treatment of CGUC using NSAIDs, mitoxantrone (MTX), and a standardized RT protocol (57 Gy in 20 fractions). Animals Fifty‐one client‐owned dogs treated between 2008 and 2017. Methods Dogs were retrospectively categorized into treatment groups: (a) first‐line concurrent chemoradiotherapy (≥1 dose of MTX started within 1 month of RT); (b) first‐line chemotherapy (MTX administered for >1 month before RT without tumor progression); (c) RT as a salvage procedure (MTX, surgery or both with subsequent locoregional tumor progression before RT). Treatment‐induced toxicoses, event‐free survival (EFS), and overall survival times (OSTs) were recorded. The influence of demographics, staging, and treatment‐related factors on survival was assessed using Cox proportional hazards modeling. Results Median EFS and OST for all dogs were 260 and 510 days with no significant differences among groups 1 (n = 39), 2 (n = 4), and 3 (n = 8). Both EFS and OST were shorter in dogs with moderate to severe clinical signs ( P < .001 and P < .001, respectively); OST was shorter in dogs with prostatic involvement ( P = .02). Permanent urinary incontinence developed in 16 dogs (31%) at a median of 70 days postirradiation; other toxicoses were mild and self‐limiting. Conclusions and Clinical Importance Mild clinical signs and lack of prostate involvement were associated with favorable prognosis for survival. Client education regarding the risk of urinary incontinence is warranted.}, number={2}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Clerc-Renaud, Benoit and Gieger, Tracy L. and LaRue, Susan M. and Nolan, Michael W.}, year={2021}, month={Mar}, pages={1052–1061} }
 @article{gieger_nolan_2021, title={Treatment outcomes and target delineation utilizingCTandMRIin 13 dogs treated with a uniform stereotactic radiation therapy protocol (16 Gy single fraction) for pituitary masses: (2014-2017)}, volume={19}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12627}, abstractNote={Abstract Canine pituitary tumours are increasingly treated with stereotactic radiotherapy (SRT). Here, we report clinical outcomes in dogs treated with single‐fraction SRT; we also explore technical aspects of SRT treatment planning. A single‐institution retrospective study was performed, including any dog with a pituitary mass (PM) that was treated using a standardized single‐fraction (16 Gy) SRT protocol between 2014 and 2017. Via medical records review, 13 cases were identified. Nine dogs neurologically improved after SRT. Four dogs experienced MRI‐documented tumour volume reduction. Nine dogs experienced neurologic decline in 1.5 to 18 months after SRT and were euthanized. The median overall survival time was 357 days, with 15% alive 18 months after SRT. To better understand whether SRT target delineation is predictably altered by use of magnetic resonance imaging (MRI) in addition to computed tomography (CT), two radiation oncologists (RO) retrospectively re‐evaluated all imaging studies used for SRT planning in these 13 cases. Gross tumour volume (GTV) was contoured on co‐registered CT and MRIs for each case. In seven cases, CT alone was deemed inadequate for GTV contouring by at least one RO. T1 post‐contrast MRI was considered the ideal image for GTV contouring in 11 cases. Contouring on MRI yielded larger GTV than CT for 11 cases. Inter‐observer variability existed in each case and was greater for MRI. In summary, use of co‐registered CT and MRI images is generally considered advantageous for PM delineation when using SRT. Notably, survival times reported herein are shorter than what has previously been reported for PM treated with finely fractionated full‐course RT protocols.}, number={1}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Gieger, Tracy L. and Nolan, Michael W.}, year={2021}, month={Mar}, pages={17–24} }
 @article{crownshaw_mcentee_nolan_gieger_2020, title={Evaluation of variables associated with outcomes in 41 dogs with incompletely excised high-grade soft tissue sarcomas treated with definitive-intent radiation therapy with or without chemotherapy}, volume={256}, ISSN={["1943-569X"]}, DOI={10.2460/javma.256.7.783}, abstractNote={Abstract OBJECTIVE To evaluate potential prognostic indicators for local recurrence, distant metastasis, and survival time in dogs with incompletely excised high-grade soft tissue sarcomas (HGSTSs), as defined by a mitotic index ≥ 9, that underwent definitive-intent radiation treatment (RT; ≥ 48 Gy total dose) with or without adjuvant chemotherapy. ANIMALS 41 client-owned dogs with HGSTSs treated with surgical resection followed by definitive-intent RT between January 1, 2000, and December 31, 2016. PROCEDURES Medical records were reviewed retrospectively, and data were collected. The Kaplan-Meier method was used to evaluate the overall survival time (OST) of dogs and time to progression (TTP) of disease, starting from the first day of RT. The Cox proportional hazards model was used to analyze the impact of results for several variables on OST and TTP. RESULTS The median OST was 981 days, with 1-, 3-, and 5-year survival rates of 85%, 43%, and 18%, respectively. The median TTP was not reached; however, the mean TTP was 1,581 days. Ten of the 41 (24%) dogs developed metastasis, and 8 (20%) developed local recurrence. Sixteen of the 41 dogs received chemotherapy. The hazard of disease progression over the study period increased as the mitotic index (hazard ratio [HR], 1.115) or duration of RT (HR, 1.427) increased. The hazard of death over the study period increased as the RT duration (HR, 1.372) or surgical scar length (HR, 1.272) increased. CONCLUSIONS AND CLINICAL RELEVANCE Although adjuvant chemotherapy was not associated with improved survival time in dogs of the present study, results indicated that improved OST and TTP could be achieved through strict adherence to the prescribed irradiation schedule and avoidance of unnecessary prolongation of the course of RT.}, number={7}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Crownshaw, Abigail H. and McEntee, Margaret C. and Nolan, Michael W. and Gieger, Tracy L.}, year={2020}, month={Apr}, pages={783–791} }
 @article{turek_ladue_looper_nagata_shiomitsu_keyerleber_buchholz_gieger_hetzel_2020, title={Multimodality treatment including ONCEPT for canine oral melanoma: A retrospective analysis of 131 dogs}, volume={61}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12860}, abstractNote={Abstract Canine oral melanoma (OM) is an aggressive cancer with a high rate of metastasis. Surgery and/or radiotherapy (RT) are effective local treatments, yet many dogs succumb to distant metastasis. Immunotherapy represents an attractive strategy for this potentially immunogenic tumor. The objective of this multi‐institutional retrospective study was to examine the clinical outcome of dogs with OM treated with ONCEPT melanoma vaccine. Most dogs also underwent surgery and/or RT (8 Gy × four weekly fractions). Dogs with distant metastasis at diagnosis and those receiving concurrent chemotherapy were excluded. One hundred thirty‐one dogs treated with ONCEPT were included: 62 had adequate local tumor control defined as complete tumor excision or irradiation of residual microscopic disease; 15 were treated in the microscopic disease setting following an incomplete excision without adjuvant RT; and 54 had gross disease. Median time to progression, median progression‐free survival, and median tumor‐specific overall survival were 304, 260, and 510 days, respectively. In multivariable analysis, presence of gross disease correlated negatively with all measures of clinical outcome. Other negative prognostic indicators were primary tumor ≥2 cm, higher clinical stage (stages 2 and 3), presence of lymph node metastasis at diagnosis, and caudal location in the oral cavity. Radiotherapy had a protective effect against tumor progression. To date, this is the largest reported series of dogs with OM treated with ONCEPT. Several previously reported prognostic indicators were confirmed.}, number={4}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Turek, Michelle and LaDue, Tracy and Looper, Jayme and Nagata, Koichi and Shiomitsu, Keijiro and Keyerleber, Michele and Buchholz, Julia and Gieger, Tracy and Hetzel, Scott}, year={2020}, month={Jul}, pages={471–480} }
 @article{elliott_looper_keyerleber_turek_blackwood_henry_gieger_2020, title={Response and outcome following radiation therapy of macroscopic canine plasma cell tumours}, volume={18}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12600}, abstractNote={Abstract Thirty dogs with macroscopic plasma cell tumours (PCTs) were treated with radiation therapy (RT). Twelve patients were treated with palliative‐intent prescriptions (range, 4‐10 Gy/fraction (median, 7 Gy/fraction) for a total dose of 20 to 35 Gy (median total dose 30 Gy). Eighteen patients received definitive‐intent prescriptions (range, 3.0‐4.2 Gy/fraction (median, 3 Gy/fraction) for a total dose of 42 to 54 Gy (median total dose 48 Gy). Involved sites included the oral cavity, skin, multiple myeloma (MM)‐associated lytic bone lesions, bone (solitary osseous plasmacytoma; SOP), nasal cavity, larynx, retrobulbar space, lymph node and rectum. Ninety‐five percent of evaluable dogs had a complete (CR; 16/22) or partial response (PR; 5/22). Patients with MM experienced significant analgesia. The median progression‐free survival (PFS) was 611 days (range: 36‐2001 days). Events in the non‐MM cases included in‐field progression (5/26, 19%) and disseminated disease (5/26, 19%). The median survival time (MST) for all dogs was 697 days (range: 71‐2075 days), and when only non‐MM cases were considered, MST was 771 days (range: 71‐2075 days). Fourteen patients were alive without disease progression or had died of unrelated causes. Achievement of a PR was associated with an inferior PFS and MST as compared with CR. Palliative‐intent RT was associated with inferior MST as compared with definitive‐intent RT. RT is a useful therapeutic modality for PCTs and tumour responses are often complete and durable, with protracted survivals. The optimal radiation dose and schedule are yet to be defined.}, number={4}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Elliott, James and Looper, Jayme and Keyerleber, Michele and Turek, Michelle and Blackwood, Laura and Henry, Joshua and Gieger, Tracy}, year={2020}, month={Dec}, pages={718–726} }
 @article{gieger_nolan_roback_suter_2019, title={Implementation of total body photon irradiation as part of an institutional bone marrow transplant program for the treatment of canine lymphoma and leukemias}, volume={60}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12776}, abstractNote={Abstract A total body irradiation (TBI) protocol was developed to support a bone marrow transplant (BMT) program for the treatment of canine hematologic malignancies. The purpose of this prospective study is to describe implementation of the protocol and resultant dosimetry. Nongraphic manual treatment planning using 6 MV photons, isocentric delivery, 40 × 40 cm field size, wall‐mounted lasers to verify positioning, a lucite beam spoiler (without use of bolus material), a dose rate of 8.75 cGy/min at patient isocenter, and a source‐to‐axis distance of 338 cm were used for TBI. A monitor unit calculation formula was derived using ion chamber measurements and a solid water phantom. Five thermoluminescent dosimeters (TLDs) were used at various anatomic locations in each of four cadaver dogs, to verify fidelity of the monitor unit formula prior to clinical implementation. In vivo dosimetric data were then collected with five TLDs at various anatomic locations in six patients treated with TBI. A total dose of 10 Gy divided into two 5 Gy fractions was delivered approximately 16 h apart, immediately followed by autologous stem cell transplant. The mean difference between prescribed and delivered doses ranged from 99% to 109% for various sites in cadavers, and from 83% to 121% in clinical patients. The mean total body dose in cadavers and clinical patients when whole body dose was estimated by averaging doses measured by variably placed TLDs ranged from 98% to 108% and 93% to 102% of the prescribed dose, respectively, which was considered acceptable. This protocol could be used for institutional implementation of TBI.}, number={5}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Gieger, Tracy L. and Nolan, Michael W. and Roback, Donald M. and Suter, Steven E.}, year={2019}, month={Sep}, pages={586–593} }
 @article{magestro_cahoon_gieger_nolan_2019, title={Radiotherapy isocenters verified by matching to bony landmarks of the canine and feline head differ when localized using volumetric versus planar imaging}, volume={17}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12522}, abstractNote={Abstract The “gold standard” for verification of patient positioning before linear accelerator‐based stereotactic radiation therapy is kilovoltage cone‐beam computed tomography (kV‐CBCT), which is not uniformly available or utilized; planar imaging is sometimes used instead. The primary aim of this study was to determine if the position of the bony skull, when used as a surrogate for isocenter verification, is different when orthogonal megavoltage (MV) portal or kilovoltage (kV/kV) radiographs are used for image guidance, rather than kV‐CBCT. A secondary aim was to determine the influence of intra‐observer variability, body size and skull conformation on positioning, as determined using these three imaging modalities. Dogs and cats receiving radiotherapy of the head were recruited for this prospective analytical study. Planar (MV portal and kV/kV images) and volumetric (kV‐CBCT) images were acquired before treatment, and manually coregistered with reference images. Differences in skull position when matched based on MV portal, kV/kV images and kV‐CBCT were compared. A total of 65 subjects and 148 unique datasets were evaluated. The Wilcoxon rank‐sum test was used to evaluate effects of transitioning between imaging modalities. When comparing magnitude of shifts in MV to kV‐CBCT, MV to kV/kV and kV/kV to kV‐CBCT, there were statistically significant differences. Results were not measurably impacted by body size, skull conformation or interobserver differences. Based on shift magnitude and direction, an isotropic setup margin of at least 1 mm should be incorporated within the planning target volume when MV or kV planar imaging is used for position verification.}, number={4}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Magestro, Leanne M. and Cahoon, Joyce Y. and Gieger, Tracy L. and Nolan, Michael W.}, year={2019}, month={Dec}, pages={562–569} }
 @article{nolan_gieger_2019, title={Update in Veterinary Radiation Oncology Focus on Stereotactic Radiation Therapy}, volume={49}, ISSN={["1878-1306"]}, DOI={10.1016/j.cvsm.2019.05.001}, abstractNote={Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are needed, and a unique biological mechanism distinguishes SRT from other forms of external beam radiotherapy. Families find the convenient schedules and minimal acute toxicity of SRT appealing. Common indications in veterinary oncology include nasal, brain, and bone tumors. Many other solid tumors can also be treated, including spinal, oral, lung, heart-base, liver, adrenal, and prostatic malignancies. Accessibility of SRT is improving, and new data are constantly emerging to define parameters for appropriate case selection, radiation dose prescription, and long-term follow-up.”}, number={5}, journal={VETERINARY CLINICS OF NORTH AMERICA-SMALL ANIMAL PRACTICE}, author={Nolan, Michael W. and Gieger, Tracy L.}, year={2019}, month={Sep}, pages={933-+} }
 @article{kelsey_gieger_nolan_2018, title={Single fraction stereotactic radiation therapy (stereotactic radiosurgery) is a feasible method for treating intracranial meningiomas in dogs}, volume={59}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12636}, abstractNote={Abstract The aim of this retrospective, pilot study was to evaluate stereotactic radiosurgery as a method for treating intracranial meningiomas in dogs. Included dogs had an imaging diagnosis of presumed intracranial meningioma, were treated using a standardized stereotactic radiosurgery protocol, and had a follow‐up time of >6 months after stereotactic radiosurgery. A single fraction of 16 Gy stereotactic radiosurgery was delivered to the tumor, with an internal simultaneously integrated boost to a total dose of 20–24 Gy to the central portion of the tumor. Thirty‐two dogs were sampled. One dog was euthanized in the periprocedural period, and 10 of the remaining 31 dogs (31%) experienced an acute adverse event (defined as declining neurologic function due to tumor progression or treatment‐associated complication within the first 6 months after stereotactic radiosurgery), three of which were fatal. Too few subjects ( n = 6) had cross‐sectional imaging after stereotactic radiosurgery to determine an objective response rate; however, 17/30 (57%) dogs assessed for response had a perceived clinical benefit from treatment. The overall median survival time was 519 days (95% confidence interval: 330–708 days); 64% and 24% of dogs were alive at 1 and 2 years after stereotactic radiosurgery, respectively. Dogs with infratentorial tumor location and high gradient indices had shorter survival. There were no factors identified which were predictive of acute adverse event. Survival times reported herein are similar to what has previously been reported for other stereotactic and traditional fractionated radiotherapy protocols. Findings therefore supported the use of stereotactic radiosurgery as an alternative method for treating dogs with presumed intracranial meningiomas.}, number={5}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Kelsey, Krista L. and Gieger, Tracy L. and Nolan, Michael W.}, year={2018}, pages={632–638} }
 @article{magestro_gieger_nolan_2018, title={Stereotactic body radiation therapy for heart-base tumors in six dogs}, volume={20}, ISSN={["1875-0834"]}, DOI={10.1016/j.jvc.2018.04.001}, abstractNote={Heart-base tumors are increasingly treated with radiotherapy, yet safety and efficacy are incompletely understood. This case series describes outcomes after stereotactic body radiation therapy (SBRT) for presumed chemodectoma. Six pet dogs. A retrospective study was performed, including dogs with a clinical diagnosis of chemodectoma and treatment with three-fraction SBRT (30 Gy total). Heart-base tumors, presumed or confirmed to be chemodectomas, were diagnosed via histopathology or imaging. Treatment was delivered with intensity modulation and cone-beam computed tomography–based image guidance, using a linear accelerator and robotic couchtop. Intrafraction respiratory motion was managed with either neuromuscular blockade and breath-holding (n = 3) or high-frequency jet ventilation (n = 3); mean total anesthesia times for each technique were 165 and 91 min per fraction, respectively. Four tumors were assessed after SBRT; tumor volume decreased by 30–76%. Possible treatment-related complications included cough, tachyarrhythmias, and congestive heart failure. Two dogs experienced sudden death 150 and 294 days after SBRT. Three dogs are alive 408–751 days after SBRT, and one dog died of unrelated disease 1,228 days after SBRT. This SBRT protocol resulted in rapid tumor volume reduction, and jet ventilation effectively reduced treatment delivery times. However, cardiac arrhythmias (presumably tumor or treatment associated) and sudden death were common after SBRT. Therefore, SBRT is a potentially useful treatment but may not be appropriate for dogs with incidentally diagnosed, slowly growing tumors, which are not causing cardiovascular disturbances. Longer follow-up and larger case numbers are needed to more completely define safety and impact of treatment on long-term survivability.}, number={3}, journal={JOURNAL OF VETERINARY CARDIOLOGY}, author={Magestro, L. M. and Gieger, T. L. and Nolan, M. W.}, year={2018}, month={Jun}, pages={186–197} }
 @article{mutz_boudreaux_royal_merchant_pucheu-haston_griffith_gieger_2017, title={Cytologic comparison of the percentage of mast cells in lymph node aspirate samples from clinically normal dogs versus dogs with allergic dermatologic disease and dogs with cutaneous mast cell tumors}, volume={251}, ISSN={["1943-569X"]}, DOI={10.2460/javma.251.4.421}, abstractNote={OBJECTIVE To compare percentages of mast cells in lymph node (LN) aspirate samples from clinically normal dogs, dogs with allergic dermatologic disease (ADD), and dogs with cutaneous mast cell tumors (MCTs). DESIGN Prospective cross-sectional study. ANIMALS 20 healthy dogs (group 1), 20 dogs with ADD (group 2), and 20 dogs with an MCT on the head or limbs (group 3). PROCEDURES LN aspirate samples were obtained from easily accessible LNs in group 1, affected skin regions in group 2, and the likely draining LN or LNs of the MCT in group 3; the percentage of mast cells was manually determined for each LN. For group 3, LNs were cytologically categorized with a modified version of a published metastasis categorization scheme. RESULTS Median (range) percentage of mast cells in aspirate samples was 0% (0% to 0.1%) for group 1, 0.05% (0% to 0.55%) for group 2, and 0.4% (0% to 77.4%) for group 3. In group 3, 16 LNs (13 dogs) were palpably normal in size; 6 of these had evidence of possible or certain metastasis. Seven LNs (7 dogs) in group 3 were palpably enlarged, and 5 of these had evidence of certain metastasis. CONCLUSIONS AND CLINICAL RELEVANCE This study provided evidence to support the use of a uniform cytologic grading system to further define nodal metastasis in dogs with MCTs as well as estimates of the percentage of mast cells in LN aspirate samples for healthy dogs and dogs with ADD. Palpably normal LNs in dogs with cutaneous MCT may contain metastasis.}, number={4}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Mutz, Melanie L. and Boudreaux, Bonnie B. and Royal, Angela and Merchant, Sandra and Pucheu-Haston, Cherie and Griffith, Emily H. and Gieger, Tracy L.}, year={2017}, month={Aug}, pages={421–428} }
 @article{gieger_nolan_2017, title={Management of radiation side effects to the skin}, volume={47}, number={6}, journal={Veterinary Clinics of North America. Small Animal Practice}, author={Gieger, T. and Nolan, M.}, year={2017}, pages={1165-} }
 @article{nolan_gieger_karakashian_nikolova-karakashian_posner_roback_rivera_chang_2017, title={Outcomes of Spatially Fractionated Radiotherapy (GRID) for Bulky Soft Tissue Sarcomas in a Large Animal Model}, volume={16}, ISSN={1533-0346 1533-0338}, url={http://dx.doi.org/10.1177/1533034617690980}, DOI={10.1177/1533034617690980}, abstractNote={GRID directs alternating regions of high- and low-dose radiation at tumors. A large animal model mimicking the geometries of human treatments is needed to complement existing rodent systems (eg, microbeam) and clarify the physical and biological attributes of GRID. A pilot study was undertaken in pet dogs with spontaneous soft tissue sarcomas to characterize responses to GRID. Subjects were treated with either 20 Gy (3 dogs) or 25 Gy (3 dogs), delivered using 6 MV X-rays and a commercial GRID collimator. Acute toxicity and tumor responses were assessed 2, 4, and 6 weeks later. Acute Radiation Therapy Oncology Group grade I skin toxicity was observed in 3 of the 6 dogs; none experienced a measurable response, per Response Evaluation Criteria in Solid Tumors. Serum vascular endothelial growth factor, tumor necrosis factor α, and secretory sphingomyelinase were assayed at baseline, 1, 4, 24, and 48 hours after treatment. There was a trend toward platelet-corrected serum vascular endothelial growth factor concentration being lower 1 and 48 hours after GRID than at baseline. There was a significant decrease in secretory sphingomyelinase activity 48 hours after 25 Gy GRID ( P = .03). Serum tumor necrosis factor α was quantified measurable at baseline in 4 of the 6 dogs and decreased in each of those subjects at all post-GRID time points. The new information generated by this study includes the observation that high-dose, single fraction application of GRID does not induce measurable reduction in volume of canine soft tissue sarcomas. In contrast to previously published data, these data suggest that GRID may be associated with at least short-term reduction in serum concentration of vascular endothelial growth factor and serum activity of secretory sphingomyelinase. Because GRID can be applied safely, and these tumors can be subsequently surgically resected as part of routine veterinary care, pet dogs with sarcomas are an appealing model for studying the radiobiologic responses to spatially fractionated radiotherapy.}, number={3}, journal={Technology in Cancer Research & Treatment}, publisher={SAGE Publications}, author={Nolan, Michael W. and Gieger, Tracy L. and Karakashian, Alexander A. and Nikolova-Karakashian, Mariana N. and Posner, Lysa P. and Roback, Donald M. and Rivera, Judith N. and Chang, Sha}, year={2017}, month={Feb}, pages={357–365} }
 @article{nolan_arkans_lavine_defrancesco_myers_griffith_posner_keene_tou_gieger_et al._2017, title={Pilot study to determine the feasibility of radiation therapy for dogs with right atrial masses and hemorrhagic pericardial effusion}, volume={19}, ISSN={1760-2734}, url={http://dx.doi.org/10.1016/j.jvc.2016.12.001}, DOI={10.1016/j.jvc.2016.12.001}, abstractNote={To determine the short-term safety and biologic activity of radiation therapy (RT) for presumptive cardiac hemangiosarcoma in pet dogs. Six dogs with echocardiographic evidence of a right atrial/auricular mass, and hemorrhagic pericardial effusion, were enrolled in a prospective, single-arm clinical trial. A single fraction of 12 Gy was delivered using conformal external beam irradiation. Serum cardiac troponin I and plasma concentrations of vascular endothelial growth factor were quantified before, 4 and 24 h after RT. The frequency of required pericardiocenteses (quantified as the number of pericardiocenteses per week) before RT was compared to that after treatment. Overall survival time was determined. No treatment-related complications were observed. Pericardiocentesis was performed an average of 0.91 times per week before RT, and an average of 0.21 times per week after RT; this difference was statistically significant (p=0.03, as compared using a Wilcoxon signed-rank test of paired data). Pre- and post-treatment plasma vascular endothelial growth factor concentrations were not significantly different at any time point; there was a statistically significant (p=0.04; Friedman's test for non-parametric repeated measures) increase in cardiac troponin concentrations 4 h after irradiation. Median overall survival time was 79 days. In this population of dogs, RT was delivered without complication, and appears to have reduced the frequency of periacardial tamponade that necessitated pericardiocentesis. Serum cardiac troponin levels are altered after RT. RT alone, or in combination with chemotherapy, may provide clinical benefit to dogs with presumptive diagnoses of cardiac hemangiosarcoma.}, number={2}, journal={Journal of Veterinary Cardiology}, publisher={Elsevier BV}, author={Nolan, M.W. and Arkans, M.M. and LaVine, D. and DeFrancesco, Teresa and Myers, J.A. and Griffith, E.H. and Posner, L.P. and Keene, B.W. and Tou, S.P. and Gieger, Tracy and et al.}, year={2017}, month={Apr}, pages={132–143} }
 @article{gieger_nettifee-osborne_hallman_johannes_clarke_nolan_williams_2017, title={The impact of carboplatin and toceranib phosphate on serum vascular endothelial growth factor (VEGF) and metalloproteinase-9 (MMP-9) levels and survival in canine osteosarcoma}, volume={81}, number={3}, journal={Canadian Journal of Veterinary Research}, author={Gieger, T. L. and Nettifee-Osborne, J. and Hallman, B. and Johannes, C. and Clarke, D. and Nolan, M. W. and Williams, L. E.}, year={2017}, pages={199–205} }
 @article{adamson_mein_meng_gunasingha_yoon_miles_walder_fathi_beyer_spector_et al._2017, title={Utilizing a diagnostic kV imaging system for x-ray psoralen activated cancer therapy (X-PACT)}, volume={3}, number={3}, journal={Biomedical Physics & Engineering Express}, author={Adamson, J. and Mein, S. and Meng, B. and Gunasingha, R. and Yoon, S. W. and Miles, D. and Walder, H. and Fathi, Z. and Beyer, W. and Spector, N. and et al.}, year={2017} }
 @article{magestro_gieger_2016, title={Detection of synchronous primary tumours and previously undetected metastases in 736 dogs with neoplasia undergoing CT scans for diagnostic, staging and/or radiation treatment planning purposes}, volume={15}, ISSN={1476-5810}, url={http://dx.doi.org/10.1111/vco.12201}, DOI={10.1111/vco.12201}, abstractNote={The purpose of our study was to describe synchronous primary tumours and previously undetected metastases in 736 dogs with confirmed neoplasia in which computed tomography (CT) scans were performed for diagnostic, staging and/or radiation treatment planning purposes. All CTs were reviewed by a radiologist. Tumour-associated CT abnormalities were detected in 38/736 (5%), including confirmed or suspected synchronous primary neoplasms (n = 24), metastases of the primary tumour (n = 9) or both (n = 3). In lymph nodes (LN) that were considered abnormal on CT scan and were aspirated, 23% contained metastasis, and 6% of 'normal' appearing LN that were aspirated contained metastasis. Thorough evaluation of CTs and routine aspiration of regional LN are critical because results affect recommendations to perform additional staging tests and treatment for the primary and secondary tumour(s).}, number={2}, journal={Veterinary and Comparative Oncology}, publisher={Wiley}, author={Magestro, L. M. and Gieger, T. L.}, year={2016}, month={May}, pages={576–581} }
 @article{swisher_phillips_tobias_cullen_gieger_grunkemeyer_2016, title={External beam radiation therapy of squamous cell carcinoma in the beak of an African grey parrot (Psittacus timneh)}, volume={30}, DOI={10.1647/2015-106}, abstractNote={Squamous cell carcinoma has been reported in a variety of bird species, most commonly psittacine and gallinaceous birds. The long-term prognosis in nongallinaceous birds is generally poor if complete surgical excision is not possible. Squamous cell carcinoma of the rhinotheca was diagnosed in a 34-year-old timneh African grey parrot (Psittacus timneh) with a 2-year history of beak abnormalities. No evidence of metastasis or local invasion were found on results of radiographs or computed tomography scan. The bird was treated with surgical debulking and palliative megavoltage radiation therapy. After 4 radiation treatments, the affected tissue was necrotic and was debrided to reveal healthy granulation tissue. The bird died approximately 7 months after diagnosis and 4 months after cessation of radiation treatment. At the time of death, a small scab lesion remained at the left oral commissure, but no visible tumor regrowth was evident. A postmortem examination was not performed, however, and tumor recurrence could not be ruled out in this bird.}, number={3}, journal={Journal of Avian Medicine and Surgery}, author={Swisher, S. D. and Phillips, K. L. and Tobias, J. R. and Cullen, J. M. and Gieger, Tracy and Grunkemeyer, V. L.}, year={2016}, pages={250–256} }
 @article{nolan_gieger_vaden_2015, title={Management of transitional cell carcinoma of the urinary bladder in dogs: Important challenges to consider}, volume={205}, ISSN={["1532-2971"]}, DOI={10.1016/j.tvjl.2015.03.022}, number={2}, journal={VETERINARY JOURNAL}, author={Nolan, Michael W. and Gieger, Tracy L. and Vaden, Shelly L.}, year={2015}, month={Aug}, pages={126–127} }
 @article{arkans_gieger_nolan_2015, title={Misadministration of radiation therapy in veterinary medicine: a case report and literature review}, volume={15}, ISSN={1476-5810}, url={http://dx.doi.org/10.1111/vco.12161}, DOI={10.1111/vco.12161}, abstractNote={Abstract Recent technical advancements in radiation therapy have allowed for improved targeting of tumours and sparing nearby normal tissues, while simultaneously decreasing the risk for medical errors by incorporating additional safety checks into electronic medical record keeping systems. The benefits of these new technologies, however, depends on their proper integration and use in the oncology clinic. Despite the advancement of technology for treatment delivery and medical record keeping, misadministration errors have a significant impact on patient care in veterinary oncology. The first part of this manuscript describes a medical incident that occurred at an academic veterinary referral hospital, in a dog receiving a combination of stereotactic radiation therapy and full‐course intensity‐modulated, image‐guided radiation therapy. The second part of the report is a literature review, which explores misadministration errors and novel challenges which arise with the implementation of advancing technologies in veterinary radiation oncology.}, number={1}, journal={Veterinary and Comparative Oncology}, publisher={Wiley}, author={Arkans, M. M. and Gieger, T. L. and Nolan, M. W.}, year={2015}, month={Jul}, pages={237–246} }
 @article{keller_nevarez_rodriguez_gieger_gumber_2014, title={DIAGNOSIS AND TREATMENT OF ANAPLASTIC MAMMARY CARCINOMA IN A SUGAR GLIDER (PETAURUS BREVICEPS)}, volume={23}, ISSN={["1931-6283"]}, DOI={10.1053/j.jepm.2014.06.008}, abstractNote={A 9-year-old female sugar glider (Petaurus breviceps) was evaluated for a tissue mass near the marsupium. Ultrasonography identified a vascular mass originating from the right mammary gland. Fine-needle aspiration was suggestive of a malignant neoplasm. The glider was anesthetized and the tumor was removed, and this was followed by strontium-90 plesiotherapy to the tumor bed in an attempt to decrease local recurrence. Histopathology revealed an anaplastic mammary carcinoma. The glider was euthanized less than 14 days after the procedure owing to self-mutilation behavior of unknown etiology. This report is the first to describe the clinical presentation, diagnostics, therapeutics, and treatment response for a sugar glider with mammary neoplasia.}, number={3}, journal={JOURNAL OF EXOTIC PET MEDICINE}, author={Keller, Krista A. and Nevarez, Javier G. and Rodriguez, Daniel and Gieger, Tracy and Gumber, Sanjeev}, year={2014}, month={Jul}, pages={277–282} }
 @article{bigio marcello_gieger_jiménez_granger_2013, title={Detection of comorbidities and synchronous primary tumours via thoracic radiography and abdominal ultrasonography and their influence on treatment outcome in dogs with soft tissue sarcomas, primary brain tumours and intranasal tumours}, volume={13}, ISSN={1476-5810}, url={http://dx.doi.org/10.1111/vco.12063}, DOI={10.1111/vco.12063}, abstractNote={Abstract Canine soft tissue sarcomas ( STS ), primary brain tumours and intranasal tumours are commonly treated with radiotherapy ( RT ). Given the low metastatic potential of these tumours, recommendations regarding imaging tests as staging are variable among institutions. The purpose of our study was to describe thoracic radiographic and abdominal ultrasonographic findings in dogs with these neoplasms and to investigate association of abnormal findings with alterations in recommended treatment. Medical records from 101 dogs, each having thoracic radiographs and abdominal ultrasound performed as part of their staging, were reviewed. In 98 of 101 (97%), imaging abnormalities were detected, 27% of which were further investigated with fine needle aspiration cytology or biopsy. Nine percent of the detected abnormalities were considered serious comorbidities that altered treatment recommendations, including 3 (3%) which were confirmed as synchronous primary neoplasms. These findings may influence recommendations regarding the decision to perform thoracic radiographs and abdominal ultrasound prior to initiation of RT .}, number={4}, journal={Veterinary and Comparative Oncology}, publisher={Wiley}, author={Bigio Marcello, A. and Gieger, T. L. and Jiménez, D. A. and Granger, L. Abbigail}, year={2013}, month={Aug}, pages={433–442} }
 @article{northrup_rassnick_gieger_kosarek_mcfadden_rosenberg_2013, title={Prospective Evaluation of Biweekly Streptozotocin in 19 Dogs with Insulinoma}, volume={27}, ISSN={0891-6640}, url={http://dx.doi.org/10.1111/jvim.12086}, DOI={10.1111/jvim.12086}, abstractNote={Background Administration of streptozotocin (STZ) at a 21-day interval has been described in dogs with stage II and III insulinoma. Myelosuppression was not observed, suggesting the possibility of increasing dose intensity by decreasing the interval between doses. Objective To describe the tolerability of a biweekly STZ protocol. A secondary objective was to describe the outcome of dogs treated with this protocol. Animals Nineteen dogs with residual local, metastatic, or recurrent insulinoma. Methods After surgery for insulinoma, or at the time of recurrence, dogs were treated with a previously described STZ and saline diuresis protocol. Treatments were administered every 14 days. All dogs received antiemetic treatment. Adverse events (AEs) were recorded and graded. Outcome endpoints assessed were progression-free survival (PFS) and survival. Results None of the dogs experienced neutropenia or thrombocytopenia. Mild to moderate gastrointestinal toxicity was the most common AE. Diabetes mellitus was observed in 8 dogs and, in 6, resulted in euthanasia or death. Two dogs developed nephrotoxicity manifested as Fanconi syndrome in 1 and nephrogenic diabetes insipidus in the other. Six dogs developed increased alanine amino transferase activity. Hypoglycemia at the end of the STZ infusion, resulted in collapse in 1 dog and a generalized seizure in another. The median overall PFS and survival time were 196 and 308 days, respectively. Conclusions and Clinical Importance Streptozotocin can be safely administered to dogs with insulinoma, but serious AEs are possible. Additional investigation is required to better define the role of STZ in managing dogs with insulinoma.}, number={3}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Northrup, N.C. and Rassnick, K.M. and Gieger, T.L. and Kosarek, C.E. and McFadden, C.W. and Rosenberg, M.P.}, year={2013}, month={Apr}, pages={483–490} }
 @article{gieger_siegel_rosen_jackson_ware_kiselow_shiomitsu_2013, title={Reirradiation of Canine Nasal Carcinomas Treated with Coarsely Fractionated Radiation Protocols: 37 Cases}, volume={49}, ISSN={0587-2871 1547-3317}, url={http://dx.doi.org/10.5326/jaaha-ms-5920}, DOI={10.5326/jaaha-ms-5920}, abstractNote={Data from 37 dogs with nasal carcinomas treated with two or more coarsely fractionated courses of radiation therapy (RT) were retrospectively reviewed. The median radiation dose for the first course of RT was 24 Gray (Gy). All dogs clinically responded, and 11 had complete resolution of signs for a median of 114 days. Dogs were retreated at relapse, with a median dose of 20 Gy, and 26 of 37 dogs (70%) had clinical responses. The second course of RT was initiated at a median of 150 days following completion of the first course. Side effects were mild: four dogs had chronic ocular conditions necessitating medication, one of which required enucleation. Median survival time (ST) from the first dose of RT was 453 days and 180 days from the first dose of the second course of RT. The following factors were examined but were not significant for survival: total RT dose, dose of the first course of RT, complete resolution of clinical signs, use of either chemotherapy or nonsteroidal anti-inflammatory drugs (NSAIDs), and stage (T1/T2 versus T3/T4). Dogs responded well to reirradiation with a subset experiencing chronic ocular side effects.}, number={5}, journal={Journal of the American Animal Hospital Association}, publisher={American Animal Hospital Association}, author={Gieger, Tracy and Siegel, Sheri and Rosen, Kari and Jackson, Dorothy and Ware, Kevin and Kiselow, Michael and Shiomitsu, Keijiro}, year={2013}, month={Sep}, pages={318–324} }
 @article{balkman_gieger_zgola_lewis_mcentee_2012, title={In vitro characterization of docetaxel as a radiosensitizer in canine and feline cancer cell lines.}, volume={12}, DOI={10.4236/ojvm.2012.24045}, abstractNote={An In Vitro study was conducted to investigate docetaxel as a radiation sensitizer in four canine (mammary carcinoma—CMT12 and CMT25, osteosarcoma—OS2.4, and transitional cell carcinoma—PTCC), and one feline cancer cell line (oral squamous cell carcinoma—SCCF1) to provide a basis for combination therapy in clinical patients. Cells were exposed to docetaxel followed by a single dose of radiation. The percent surviving fraction was determined by MTT assay. The combination index (CI) method determined synergistic cytotoxicity for the CMT12, CMT25 and OS2.4 cell lines with median CI values of 0.35, 0.47, 0.63 respectively. The SCCF1 cell line had moderate synergistic cytotoxicity with a median CI of 0.76, while the PTCC cell line resulted in antagonistic cytoxicity with a median CI of 2.75. The results indicated that docetaxel was a radiation sensitizer in 4 out of the 5 cancer cell lines tested.}, journal={Open Journal of Veterinary Medicine}, publisher={Scientific Research Corp}, author={Balkman, C.E. and Gieger, T.L. and Zgola, M. and Lewis, L.D. and McEntee, M.}, year={2012}, month={Dec} }
 @article{ratterree_gieger_pariaut_saelinger_strickland_2012, title={Value of Echocardiography and Electrocardiography as Screening Tools Prior to Doxorubicin Administration}, volume={48}, ISSN={0587-2871 1547-3317}, url={http://dx.doi.org/10.5326/jaaha-ms-5680}, DOI={10.5326/jaaha-ms-5680}, abstractNote={The dose-limiting toxicity of doxorubicin is cardiotoxicosis. The authors of this report hypothesized that by using their institution's adopted guidelines (that involve prescreening echocardiography and electrocardiography), they would detect pre-existing cardiac abnormalities that preclude doxorubicin administration in <10% of dogs. Of 101 dogs, only 6 were excluded from doxorubicin administration based on electrocardiogram abnormalities, with a majority of those arrhythmias classified as ventricular premature contractions. One patient was excluded based on echocardiogram alone due to hypertrophic cardiomyopathy. The incidence of cardiotoxicity in treated dogs was 8% (8/101). Additional pretreatment and ongoing studies are indicated to identify risk factors for cardiotoxicity.}, number={2}, journal={Journal of the American Animal Hospital Association}, publisher={American Animal Hospital Association}, author={Ratterree, William and Gieger, Tracy and Pariaut, Romain and Saelinger, Carley and Strickland, Keith}, year={2012}, month={Mar}, pages={89–96} }
 @article{keyerleber_gieger_erb_thompson_mcentee_2011, title={Three-dimensional conformal versus non-graphic radiation treatment planning for apocrine gland adenocarcinoma of the anal sac in 18 dogs (2002-2007)}, volume={10}, ISSN={1476-5810}, url={http://dx.doi.org/10.1111/j.1476-5829.2011.00288.x}, DOI={10.1111/j.1476-5829.2011.00288.x}, abstractNote={Differences in dose homogeneity and irradiated volumes of target and surrounding normal tissues between 3D conformal radiation treatment planning and simulated non‐graphic manual treatment planning were evaluated in 18 dogs with apocrine gland adenocarcinoma of the anal sac. Overall, 3D conformal treatment planning resulted in more homogenous dose distribution to target tissues with lower hot spots and dose ranges. Dose homogeneity and guarantee of not under‐dosing target tissues with 3D conformal planning came at the cost, however, of delivering greater mean doses of radiation and of irradiating greater volumes of surrounding normal tissue structures.}, number={4}, journal={Veterinary and Comparative Oncology}, publisher={Wiley}, author={Keyerleber, M. A. and Gieger, T. L. and Erb, H. N. and Thompson, M. S. and McEntee, M. C.}, year={2011}, month={Jul}, pages={237–245} }