Characterization of normal tissue complications in 51 dogs undergoing definitive pelvic region irradiation

Our objective was to further characterize the late normal tissue complications developing after definitive irradiation of pelvic region tumors in dogs, and to search for prognostic factors. The medical records of dogs receiving definitive irradiation of the pelvic region between 1987 and 2005 were reviewed. The following criteria were established for inclusion: total dose > or =45 Gy, a portion of colon in the primary field, and a minimum of 6 months follow-up. Fifty-one dogs were identified. Prognostic factors evaluated included multiple descriptors of the patient, tumor and radiation treatment. One or more late complications were documented in 20 of 51 patients (39%). Complications were necrotic drainage/ulceration in the skin and subcutaneous tissues within the radiation field (n=7), chronic colitis (n=4), strictures (n=4), osteopenia (n=2), and one each rectal perforation, urinary bladder thickening, iliosacral osteosarcoma, pelvic limb edema, and perianal pain. Two prognostic factors were identified. There was an increase in complications in dogs with perineal tumors compared with other pelvic region sites (P = 0.04), and also in dogs with larger radiation fields (P = 0.04). The finding of an association of tumor site to complications may be a spurious finding and the association between field size and complications is not unexpected although absolute difference in field size between dogs with and without complications was small. There was no association between development of complications and survival. Based on the observed complication rate, consideration can be given to reducing dose per fraction in dogs receiving definitive pelvic region irradiation to <3 Gy.