Linear-accelerator-based modified radiosurgical treatment of pituitary tumors in cats: 11 cases (1997-2008)

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Sellon RK, Fidel J, Houston R, et al. 

Journal of veterinary internal medicine / American College of Veterinary Internal Medicine 2009;23:1038-1044.

OBJECTIVE: Determine the efficacy and safety of a linear-accelerator-based single fraction radiosurgical approach to the treatment of pituitary tumors in cats. DESIGN: Retrospective study. ANIMALS: Eleven client-owned cats referred for treatment of pituitary tumors causing neurological signs, or poorly controlled diabetes mellitus (DM) secondary either to acromegaly or pituitary-dependent hyperadrenocortism. PROCEDURES: Cats underwent magnetic resonance imaging (MRI) of the brain to manually plan radiation therapy. After MRI, modified radiosurgery was performed by delivering a single large dose (15 or 20 Gy) of radiation while arcing a linear-accelerator-generated radiation beam around the cat’s head with the pituitary mass at the center of the beam. Eight cats were treated once, 2 cats were treated twice, and 1 cat received 3 treatments. Treated cats were evaluated for improvement in endocrine function or resolution of neurological disease by review of medical records or contact with referring veterinarians and owners. RESULTS: Improvement in clinical signs occurred in 7/11 (63.6%) of treated cats. Five of 9 cats with poorly regulated DM had improved insulin responses, and 2/2 cats with neurological signs had clinical improvement. There were no confirmed acute or late adverse radiation effects. The overall median survival was 25 months (range, 1-60), and 3 cats were still alive. CONCLUSIONS AND CLINICAL IMPORTANCE: Single fraction modified radiosurgery is a safe and effective approach to the treatment of pituitary tumors in cats.