Definitive-intent intensity-modulated radiation therapy for treatment of canine prostatic carcinoma: A multi-institutional retrospective study

Jillian Z. Walz, Noopur Desai, Nathaniel Van Asselt, Valerie J. Poirier, Katherine Hansen, Laura Selmic

Research output: Contribution to journalArticle

Abstract

No standard of care is currently recognized for treatment of canine prostatic carcinoma (PC). This retrospective study assesses outcome following definitive-intent, intensity-modulated radiation therapy (RT) in dogs with PC. Medical records review was performed, including 18 patients from four institutions undergoing definitive-intent intensity-modulated radiotherapy to treat PC. Diagnosis was incidental in 7/18 (39%) patients. Five dogs (28%) had evidence of metastasis to loco-regional lymph nodes at diagnosis. Seventeen patients received concurrent non-steroidal anti-inflammatory drugs; 15/18 (83%) patients received maximally-tolerated dose (MTD) chemotherapy, with variable drugs and protocols employed. Total prescribed radiation dose ranged from 48 to 54 Gy (median 50 Gy) delivered as daily doses of 2.5-2.8 Gy. One patient was euthanized prior to completing radiotherapy. Acute toxicity was observed in nine patients; Grade 1-2 diarrhoea was the most common toxicity observed. Suspected late toxicity (urethral stricture, ureteral stricture and hindlimb oedema) was observed in three patients. Median event-free survival (EFS) following RT was 220 days, and median overall survival was 563 days. Local progression occurred in seven patients at a median of 241 days. Median overall survival was significantly longer in incidentally diagnosed dogs (581 vs 220 days in symptomatic dogs, P =.042). EFS was significantly longer in patients treated with MTD chemotherapy (241 vs 25 days, P <.001), and significantly shorter in patients presenting with evidence of metastatic disease (109 days) vs those without (388 days, P =.008). These findings suggest that definitive-intent radiotherapy is a valuable treatment option for local control of canine PC with moderate risk of toxicity.

Original languageEnglish (US)
JournalVeterinary and Comparative Oncology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

radiotherapy
retrospective studies
carcinoma
Canidae
Radiotherapy
Retrospective Studies
Carcinoma
dogs
Dogs
Therapeutics
Maximum Tolerated Dose
dosage
toxicity
drug therapy
Disease-Free Survival
therapy dogs
Drug Therapy
Urethral Stricture
Intensity-Modulated Radiotherapy
Survival

Keywords

  • dogs
  • prostatic neoplasms
  • radiotherapy, intensity-modulated
  • retrospective studies

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Definitive-intent intensity-modulated radiation therapy for treatment of canine prostatic carcinoma : A multi-institutional retrospective study. / Walz, Jillian Z.; Desai, Noopur; Van Asselt, Nathaniel; Poirier, Valerie J.; Hansen, Katherine; Selmic, Laura.

In: Veterinary and Comparative Oncology, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "No standard of care is currently recognized for treatment of canine prostatic carcinoma (PC). This retrospective study assesses outcome following definitive-intent, intensity-modulated radiation therapy (RT) in dogs with PC. Medical records review was performed, including 18 patients from four institutions undergoing definitive-intent intensity-modulated radiotherapy to treat PC. Diagnosis was incidental in 7/18 (39{\%}) patients. Five dogs (28{\%}) had evidence of metastasis to loco-regional lymph nodes at diagnosis. Seventeen patients received concurrent non-steroidal anti-inflammatory drugs; 15/18 (83{\%}) patients received maximally-tolerated dose (MTD) chemotherapy, with variable drugs and protocols employed. Total prescribed radiation dose ranged from 48 to 54 Gy (median 50 Gy) delivered as daily doses of 2.5-2.8 Gy. One patient was euthanized prior to completing radiotherapy. Acute toxicity was observed in nine patients; Grade 1-2 diarrhoea was the most common toxicity observed. Suspected late toxicity (urethral stricture, ureteral stricture and hindlimb oedema) was observed in three patients. Median event-free survival (EFS) following RT was 220 days, and median overall survival was 563 days. Local progression occurred in seven patients at a median of 241 days. Median overall survival was significantly longer in incidentally diagnosed dogs (581 vs 220 days in symptomatic dogs, P =.042). EFS was significantly longer in patients treated with MTD chemotherapy (241 vs 25 days, P <.001), and significantly shorter in patients presenting with evidence of metastatic disease (109 days) vs those without (388 days, P =.008). These findings suggest that definitive-intent radiotherapy is a valuable treatment option for local control of canine PC with moderate risk of toxicity.",
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