Total and single doses influence the effectiveness of radiotherapy in palliative treatment of plasmacytoma.

Abstract

PURPOSE:

In a retrospective analysis of radiotherapy of plasmacytomas, the effectiveness and the prognostic factors in regard to pain reduction and recalcification were evaluated.

PATIENTS AND METHODS:

138 patients (70 women, 68 men; 15-86 years, median 61 years) were irradiated at 272 target volumes (TVs) from January 1970 to December 2003.

RESULTS:

In 192/225 TVs (85.3%), there was a pain reduction. The recalcification rate was 44.7% (51/114 TVs). Significant parameters for pain relief in the multivariate analysis were completeness of therapy (odds ratio [OR] 87.8; p < 0.001 vs. interruption), patients < 60 years (OR 23.0; p < 0.001 vs. >/= 70 years), and a single dose of 2 Gy (OR 11.0; p = 0.027 vs. 4-15.0 Gy). Significant parameters for recalcification in the multivariate analysis were concurrent chemotherapy (OR 12.3; p < 0.001 vs. no chemotherapy), no fractures in the TV (OR 5.9; p < 0.004 vs. fracture), and a dose of 40-< 50 Gy (OR 21.9; p = 0.035 vs. < 30 Gy) or >/= 50 Gy (OR 26.4; p = 0.033 vs. < 30 Gy)

CONCLUSION:

Radiotherapy is a very effective palliative treatment. Patients with a reduced general condition, with multiple bone lesions and a poor prognosis profit from short-term schemes (e.g., 1 x 8 Gy to 10 x 3 Gy). Patients in good general condition with a life expectancy of > 1 year and an osteolysis at risk of fracture, should be treated with doses up to 40-50 Gy (20-25 x 2 Gy), in order to achieve the best possible recalcification and pain relief.

• Authors: Thomas Stölting, Hellen Knauerhase, Gunther Klautke, Günther Kundt, Rainer Fietkau
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 184 Issue 9 Pg. 465-72 (Sep 2008) ISSN: 1439-099X [Electronic] Germany
• PMID: 19016025 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Calcinosis (pathology)
• Combined Modality Therapy
• Dose Fractionation, Radiation
• Female
• Humans
• Male
• Middle Aged
• Multiple Myeloma (drug therapy, mortality, pathology, radiotherapy)
• Multivariate Analysis
• Neoplasm Staging
• Pain Measurement
• Palliative Care
• Plasmacytoma (drug therapy, mortality, pathology, radiotherapy)
• Prognosis
• Radiotherapy Dosage
• Retrospective Studies
• Survival Rate
• Treatment Outcome
• Young Adult