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The role of radiotherapy in the management of POEMS syndrome.

Authors
 Yang Gun Suh  ;  Young Suk Kim  ;  Chang Ok Suh  ;  Yu Ri Kim  ;  June Won Cheong  ;  Jin Seok Kim  ;  Jaeho Cho 
Citation
 RADIATION ONCOLOGY, Vol.9 : 265, 2014 
Journal Title
 RADIATION ONCOLOGY 
Issue Date
2014
MeSH
Adult ; Aged ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; POEMS Syndrome/mortality ; POEMS Syndrome/radiotherapy* ; Retrospective Studies ; Treatment Outcome
Keywords
Chemotherapy ; Osteosclerotic myeloma ; Castleman’s disease ; Monoclonal gammopathy ; Polyneuropathy
Abstract
BACKGROUND: POEMS syndrome is a paraneoplastic syndrome caused by an underlying plasma cell proliferative disease. In this study, we examined the treatment outcomes and role of radiotherapy in the management of POEMS syndrome. METHODS: In total, 33 patients diagnosed with POEMS syndrome were analyzed. These patients presented with osteosclerotic myeloma (OSM, n = 13), Castleman's disease (CD, n = 4), OSM with CD (n = 10), and vascular endothelial growth factor elevation without gross lesions (VEGFe, n = 6), respectively. The patients were treated by radiotherapy alone (n = 4), chemotherapy alone (n = 16), or a combination thereof (n = 9). RESULTS: The clinical response rates of radiotherapy, chemotherapy, and radiotherapy plus chemotherapy were 75%, 69%, and 89%, respectively. In addition, the hematologic response rates were 50%, 69%, and 71%, respectively. Among the six patients with limited multiple lesions who underwent radiotherapy, the clinical symptoms were improved in five patients after radiotherapy. The median progression-free survival (PFS) was 51 months, and the median overall survival (OS) was 65 months. In univariate analysis, the administration of chemotherapy was significantly associated with better PFS (p = 0.007) and OS (p = 0.020). In contrast, underlying VEGFe was a significant factor worsening PFS (p = 0.035) and OS (p = 0.008). CONCLUSIONS: Radiotherapy produces a reliable clinical response and is effective in improving POEMS-associated symptoms that are refractory to chemotherapy in selected patients with clustered or limited multiple lesions that can be covered by single radiation field.
Files in This Item:
T201404231.pdf Download
DOI
10.1186/s13014-014-0265-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Suh, Yang Gun(서양권)
Suh, Chang Ok(서창옥)
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138279
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