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Imaging

Radiation therapy in veterinary medicine: a practical review

02 August 2020
Clinical
22 mins read
02 August 2020
Volume 25 · Issue 7
Figure 3. Contouring. The computed tomography images obtained during treatment simulation are imported by specialised software to contour organs at risk (eg brain – yellow line), and the tumour (red line). The pink line represents the planning target volume (ie the volume of tissue to receive the prescribed treatment dose). This volume includes the tissue affected by the cancer and an additional safety margin to account for potential variation associated with patient setup or internal movement of organs.
Figure 3. Contouring. The computed tomography images obtained during treatment simulation are imported by specialised software to contour organs at risk (eg brain – yellow line), and the tumour (red line). The pink line represents the planning target volume (ie the volume of tissue to receive the prescribed treatment dose). This volume includes the tissue affected by the cancer and an additional safety margin to account for potential variation associated with patient setup or internal movement of organs.

Abstract

Radiotherapy is a treatment modality based on the use of high-energy rays to kill neoplastic cells, which has become an integral therapeutic tool in veterinary medicine. Radiotherapy may be an effective treatment for tumours that are not easily managed with surgery or with chemotherapy, even for patients with advanced-stage neoplasia. Novel uses of radiotherapy include rescue therapy for specific benign conditions that are refractory to conventional therapy. Acute and late toxicities depend on the prescribed protocol as well as sensitivity and volume of the normal tissue in or near the radiation field. The potential risks associated with the treatment should be fully discussed with owners before starting radiotherapy. New hardware and software technology has drastically advanced the ability to precisely target tumours, improving treatment efficacy and safety.

Radiotherapy is a unique treatment modality that consists of the medical use of ionising radiation. It plays a major role in management of human cancer oncology, with approximately 50% of cancer patients receiving radiation therapy during their course of illness (Delaney et al, 2005). The use of radiotherapy in companion animal oncology has developed and expanded significantly over the past 20 years; it is currently considered a fundamental therapeutic tool (McEntee, 2004; 2006; Farrelly and McEntee, 2014; LaRue and Custis, 2014).

Ionising radiation can damage tumour cells both directly, or indirectly through formation of free radicals (Johns and Cunningham, 1969). The main target is DNA, although ionising radiation can also damage other important cellular structures such as the cytoplasmic membrane (Halperin et al, 2013; Hall and Giaccia, 2018). Tumour cells typically die following an unsuccessful attempt to divide, as a result of their damaged DNA, although exquisitely sensitive cells, such as lymphocytes, can die within hours via apoptosis. Some cells undergo senescence, where they remain alive but incapable of dividing (Ward, 1988; Harding et al, 2013).

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acute toxicity
definitive radiotherapy
external beam radiation therapy
imaging-guided radiotherapy
intensity modulated radiotherapy
late toxicity
palliative radiotherapy
radiation therapy
stereotactic radiation therapy