Radiation Therapy – A Treatment Option for Bladder and Prostate Tumors

dr-lynsday-kubicekby Lyndsay Kubicek, DVM DACVR (Radiation Oncology)
Angell Animal Medical Center


The most common type of genitourinary tract tumors in dogs is invasive transitional cell carcinoma1-4. Other carcinomas include squamous cell carcinoma, adenocarcinomas, and undifferentiated carcinomas. This group of tumors is locally invasive with a moderate-high metastatic potential to regional lymph nodes and distant sites. Mortality associated with these tumors is often attributed to urethral and/or ureteral obstruction. Survival time for patients without treatment is typically 1-2 months5.

Photos-168Treatment intent ranges from palliation of signs to aggressive curative intent therapies. The infiltrative nature of genitourinary tumors renders complete surgical excision extremely difficult with the majority of tumors recurring 3-10 months following aggressive surgical resection6-9. Other treatments include the use of nonsteroidal anti-inflammatories (NSAIDS) with median survivals of approximately 6 months with this treatment alone 10,11. The use of an NSAID can be combined with high dose chemotherapy to increase survival times to 4.3-11 months12-15.

Radiation therapy has been previously evaluated for genitourinary tract tumors in dogs. Intraoperative radiation therapy has been used post surgically for microscopic disease resulting in survival times of 4-15 months16-19. Even with the potential for benefit, the use of such protocols was associated with severe late term radiation side effects.  The inability to protect the normal structures and prevent severe late side effects was due to the limitations of the planning and delivery systems.

With the advent of newer planning and delivery techniques such as intensity-modulated radiation therapy (IMRT), we now have the ability to protect the adjacent critical structures. A new study by Nolan et al. demonstrated that image-guided intensity modulated radiation therapy was well tolerated with mild side effects. The subjective response rate was 60% and the median event-free survival time in this study was 317 days (10.4 months) and the median overall survival time was 654 days (21.6 months). This outcome appears superior to medical therapy (NSAID and or chemotherapy) with or without surgery 5, 10-19. A quality of life questionnaire was also used in this study and showed very favorable responses in regards to the owners’ perceptions of how their pets felt during and after radiation therapy. The patients in this study had various treatments before, during and after radiation therapy, however we can see that the addition of radiation therapy improved survival times with minimal impact on quality of life20.

Based on the information provided by the previously mentioned study, the addition of radiation therapy offers an exciting new tool in the treatment of genitourinary tract tumors in dogs. This treatment is available at Angell Animal Medical Center. If you would like further information please call the oncology service at 617-541-5136.



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