Adamietz I A, Schöber C, Schulte R W, Peest D, Renner K
Department of Radiotherapy, Medical School, Hannover, F.R.G.
Radiother Oncol. 1991 Feb;20(2):111-6. doi: 10.1016/0167-8140(91)90144-6.
Pain symptoms caused by bone lesions of multiple myeloma can be relieved by a local irradiation treatment. To estimate the influence of systemic treatment on the palliative effect of local radiotherapy the records of 70 myeloma patients treated with chemotherapy combined with or followed by local irradiation were reviewed. The local response rate, defined as complete pain relief at the irradiated site, was 80% in patients receiving irradiation during chemotherapy (melphalan and prednisone) and this palliative effect endured 31.8 +/- 3.6 months. If irradiation was started in the period without systemic treatment the local response rate was 39.6% and lasted 24.8 +/- 17.9 months. In sites treated with more than one radiotherapy course 94% response rate after the first treatment, 56% after the second treatment and no response after the third course was achieved. The duration of local pain control was positively related to the applied radiation dose. It is concluded that irradiation during concomitant chemotherapy is superior to radiotherapy performed in a period without systemic treatment. Local long-term palliation can only be achieved by a sufficient high radiation dose.
多发性骨髓瘤骨病变引起的疼痛症状可通过局部放射治疗缓解。为评估全身治疗对局部放疗姑息效果的影响，回顾了70例接受化疗联合局部放疗或先化疗后局部放疗的骨髓瘤患者的记录。局部缓解率定义为照射部位疼痛完全缓解，在化疗（美法仑和泼尼松）期间接受照射的患者中为80%，这种姑息效果持续31.8±3.6个月。如果在没有全身治疗的期间开始照射，局部缓解率为39.6%，持续24.8±17.9个月。在接受多个放疗疗程治疗的部位，首次治疗后缓解率为94%，第二次治疗后为56%，第三次疗程后无缓解。局部疼痛控制的持续时间与所应用的辐射剂量呈正相关。结论是，同步化疗期间的照射优于在没有全身治疗期间进行的放疗。局部长期姑息只能通过足够高的辐射剂量来实现。
