Initial evaluation of safety of wide-field irradiation in the treatment of hematopoietic neoplasia in the cat

Localized radiation therapy is well tolerated in cats with confined tumors; however, the use of wide-field radiation therapy to treat disseminated neoplasia has not been evaluated systematically in this species. Wide-field external beam radiation therapy, which we define as irradiation of cranial or caudal halves of the body either individually or sequentially, was undertaken as an experimental option to treat cats with either chemotherapy-refractory or naïve hematopoietic neoplasia considered to have a poor prognosis. Fifteen cats with hematopoietic malignancies received wide-field external beam radiation therapy between 2003 and 2006. Cats received 8Gy delivered in 4Gy fractions with ⁶⁰Co photons. Treatment-related toxicity was scored according to criteria established by the Veterinary Cooperative Oncology Group. Animals without preexisting abnormalities on hemograms exhibited no or mild (Grade 1 or 2) hematopoietic toxicity. Although most cats (14 of 15) had preexisting gastrointestinal (GI) signs, these signs were stable (29%) or improved (42%) following irradiation. Worsening GI signs following irradiation occurred transiently in two cats and in association with progressive disease in two others. No pulmonary, renal, hepatic, or dermatologic toxicities were detected. In summary, wide-field external beam radiation therapy can be administered safely to, and may provide therapeutic benefit for, cats with disseminated hematopoietic neoplasia.