In view of increasing controversy regarding the role of double
hemibody irradiation (DHBI) in the treatment of
multiple myeloma, we have analysed the use of this technique at our institution over a 6-year period. Fifty-five patients with
multiple myeloma were treated with both upper and lower
hemibody irradiation between January 1985 and January 1991; 42 had relapsed post-plateau and 13 were chemoresistant to initial
therapy. Fifteen patients received alpha IFN-2b maintenance
therapy post-DHBI, at a dose of 3 Mu three times per week, as part of a randomized trial. Ninety-five per cent of patients experienced symptomatic improvement in bone
pain post-DHBI, 21% of whom discontinued
opiate analgesics altogether; 63% had a minor biochemical response and 38% had a partial biochemical response. The overall survival (OS) and progression free survivals (PFS) in all patients were 11 months and 8 months respectively. No significant difference was noted in either OS or PFS, according to whether patients were chemoresistant or had relapsed post-plateau. alpha IFN did not appear to prolong survival (OS or PFS) post-DHBI.
Cytopenia was a significant problem, such that only 60% of patients had counts adequate enough to be eligible for alpha IFN. We conclude that DHBI is an effective treatment in patients with relapsed
multiple myeloma and in those who are chemoresistant to initial
therapy.(ABSTRACT TRUNCATED AT 250 WORDS)