If the cat has had surgery and only microscopic disease exists, we give 20 fractions of radiation at 3.0 Gy per fraction for a total of 60 Gy.

This is given MONDAY THROUGH FRIDAY and adjusted if spinal cord or other critical structures are in the field. We also follow radiation with chemotherapy, starting 2-3 weeks after radiation) consisting of 5 cycles of doxorubicin and carboplatin, one or the other given every three weeks.

If the cat has gross tumor, we will give 16 of the 20 radiation treatments BEFORE surgery is done. Generally we wait 2-3 weeks following radiation therapy before surgery is done. We then give another 4 fractions of radiation starting the day after surgery. We then follow with the chemotherapy, again starting 2-3 weeks after completion of radiation.

We have treated probably about 15 or so cats with this protocol over the last year and they tolerate it well. We have had to do additional surgeries in several cats as the high dose of radiation has caused some wound healing problems ESPECIALLY IN THE PREOPERATIVE GROUP but in general we have not had major problems. It is still too early to tell if this is more or less effective than other protocols.