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Radiotherapy for solitary plasmacytoma of bone and soft tissue: outcomes and prognostic factors

Authors
 Yang-Gun Suh  ;  Chang-Ok Suh  ;  Jin Seok Kim  ;  Soo-Jeong Kim  ;  Hae Ok Pyun  ;  Jaeho Cho 
Citation
 ANNALS OF HEMATOLOGY, Vol.91(11) : 1785-1793, 2012 
Journal Title
 ANNALS OF HEMATOLOGY 
ISSN
 0939-5555 
Issue Date
2012
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Biomarkers, Tumor/blood ; Bone Neoplasms/blood ; Bone Neoplasms/diagnosis ; Bone Neoplasms/drug therapy ; Bone Neoplasms/radiotherapy* ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Plasmacytoma/blood ; Plasmacytoma/diagnosis ; Plasmacytoma/drug therapy ; Plasmacytoma/radiotherapy* ; Prognosis ; Remission Induction ; Soft Tissue Neoplasms/blood ; Soft Tissue Neoplasms/diagnosis ; Soft Tissue Neoplasms/drug therapy ; Soft Tissue Neoplasms/radiotherapy* ; Survival Analysis ; Young Adult ; beta 2-Microglobulin/blood
Keywords
Plasmacytoma ; Extramedullary plasmacytoma ; Solitary bone plasmacytoma ; Radiotherapy
Abstract
We investigated treatment outcomes of radiotherapy for solitary plasmacytoma (SP) and prognostic factors affecting survival. Between 1996 and 2010, a total of 38 patients were treated with radiotherapy for histologically proven plasmacytoma without evidence of multiple myeloma. Among these, 16 and 22 patients had SP originating from extramedullary soft tissue (EMP) and bone, respectively. Thirteen patients received adjuvant chemotherapy, and three patients underwent surgery prior to radiotherapy. At a median follow-up of 50 months (range, 8-142), radiotherapy demonstrated excellent local control (5- and 10-year local control rates, 81%). However, the 10-year multiple myeloma-free survival (MMFS) was 54% and the 10-year overall survival (OS) rates was 35%. Solitary bone plasmacytoma (SBP) more frequently progressed to multiple myeloma (MM) than EMP (10-year MMFS, 0% vs. 71%, p = 0.02). Radiotherapy with doses ≥40 Gy demonstrated better local control (10-year LC, 100% vs. 60%, p = 0.04) in SBP. In the multivariate analysis, elevated β₂-microglobulin was a significantly unfavorable prognostic factor affecting OS (p = 0.03). In conclusion, radiotherapy effectively treated SP without significant toxicity. However, progression to MM presents a challenging problem. Novel therapeutics are needed for patients with unfavorable prognostic factors.
Full Text
http://link.springer.com/article/10.1007%2Fs00277-012-1510-6
DOI
10.1007/s00277-012-1510-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Pyun, Hae Ok(변해옥)
Suh, Yang Gun(서양권)
Suh, Chang Ok(서창옥)
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89505
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