Analysis of prognostic factors and patterns of failure in dogs with periodontal tumors treated with megavoltage irradiation

Abstract

OBJECTIVE: To determine quality and duration of progression-free survival (PFS) time in dogs with periodontal tumors after definitive megavoltage irradiation and to analyze prognostic factors for PFS time and patterns of treatment failure. DESIGN: Prospective clinical trial. ANIMALS: 47 dogs with acanthomatous, fibromatous, or ossifying epulis. PROCEDURE: Dogs were treated with 48 Gy over 4 weeks on an alternate-day schedule of 4 Gy/fraction. Multivariate analysis was done by use of Cox's proportional hazards regression model to determine prognostic factors for PFS time. RESULTS: The only independent prognostic factor for PFS time was tumor T stage. Pattern of local tumor recurrence (marginal vs infield regrowth) was independent of clinical stage, tumor location, and site. In 4% of the dogs, severe acute radiation reactions in the final week of treatment resulted in treatment discontinuation. In 6.4% of the dogs, chronic radiation reactions included bone necrosis. CLINICAL IMPLICATIONS: Irradiation was a safe and effective treatment of small (T1 and T2 stage) periodontal tumors. The usefulness of the radiation protocol in this study is limited in dogs with large (T3) tumors, particularly those located in the caudal half of the oral cavity, because of poor results and high risk of acute radiation toxicoses.