Survival and outcomes for dogs with brain tumors after advanced

Abstract

Radiation therapy (RT) is the treatment of choice for canine intracranial gliomas. Recently, modern advanced radiation techniques, including intensity modulated RT (IMRT) and volumetric modulated arc therapy (VMAT), have become widely available in veterinary medicine. However, the glioma-specific therapeutic outcomes of patients treated with modern RT remain unclear. This study aimed to describe survival outcomes and tumour response and to identify whether any treatment, clinical, and imaging factors were predictive of prognosis in dogs with intracranial gliomas treated with definitive-intent IMRT alone. Medical records of dogs with presumed intracranial gliomas that underwent definitive-intent IMRT were retrospectively reviewed. Fifty-five dogs were included. Amongst them, 29 and 26 underwent fractionated RT (FRT) and stereotactic RT (SRT), respectively. In the 44 dogs that underwent follow-up magnetic resonance imaging (MRI), the overall measurable response rate was 77.3%. Clinical improvement was observed in 92% of the dogs. Local tumour regrowth and drop metastases were observed in 17 (30.9%) and 10 dogs (18.2%), respectively. The median overall survival, disease-specific survival, and progression-free survival were 432, 670, and 441 days, respectively. Seven dogs (12.7%) died during RT or within 6 weeks. There was no statistically significant difference in the survival times between FRT and SRT. In the multivariate analysis, poor performance status, tumour location in the diencephalon, and fluid-attenuated inversion recovery heterogeneity were significantly associated with shorter survival times. These findings suggest that definitive-intent RT results in tumour shrinkage and prolonged survival (432 days) with minimal radiation toxicity regardless of the RT protocol used. Performance status and MRI findings can be useful for predicting prognosis.