Yaneva M P, Goranova-Marinova V, Goranov St
Department of Radiotherapy and Nuclear Medicine, Plovdiv, Bulgaria.
J BUON. 2006 Jan-Mar;11(1):43-8.
To analyse the therapeutic effect of palliative radiation therapy (RT) in multiple myeloma (MM) patients with bone lesions and soft tissue formations, to compare the therapeutic efficacy of two different RT regimens, the effect of RT on basic disease parameters, and its impact on survival in MM patients.
162 patients with MM were diagnosed and followed for a 10-year period (1994-2004). Eighty-seven (53.7%) of them with myeloma bone disease (MBD) underwent palliative RT with two different regimens. The effect of RT on MBD and its complications was assessed. Patients with RT were compared in 10 parameters before and after RT. Survival was compared between the irradiated and non irradiated groups and also between patients treated with two different RT regimens, using Kaplan-Meier method and log-rank test.
RT was applied in 92.1% of the patients with vertebral fractures, in 90.9% of the patients with non-vertebral fractures, and in 94.1% of the patients with extramedullary tumor formations. In 89.6% of the patients complete or partial pain palliation was achieved and in 58.6% resolution of neurologic symptoms occurred. The levels of hemoglobin (Hb), white blood cell (WBC) and platelet counts (PLT), bone marrow infiltration, serum calcium (Ca), creatinine, albumin, CRP, LDH, beta2-microglobulin did not change significantly before and after RT. Median survival of patients on RT was 32 months (range 30-34) vs. 33 months (range 28-36) for patients without RT (p>0.05). Median survival was 32 months (range 27-37) for patients on 2x8 Gy. vs. 34 months (range 25-39) for those on 5x4 Gy (p>0.05).
RT is a very effective method in bone pain palliation in vertebral and non-vertebral fractures and reduction of extramedullary formations, but does not influence the survival of patients with MM.
分析姑息性放射治疗（RT）对患有骨病变和软组织形成的多发性骨髓瘤（MM）患者的治疗效果，比较两种不同RT方案的治疗疗效、RT对基础疾病参数的影响及其对MM患者生存的影响。
162例MM患者被诊断并随访10年（1994 - 2004年）。其中87例（53.7%）患有骨髓瘤骨病（MBD）的患者接受了两种不同方案的姑息性RT。评估RT对MBD及其并发症的影响。对接受RT的患者在RT前后的10项参数进行比较。使用Kaplan - Meier方法和对数秩检验比较照射组和未照射组患者之间以及接受两种不同RT方案治疗的患者之间的生存率。
92.1%的椎体骨折患者、90.9%的非椎体骨折患者和94.1%的髓外肿瘤形成患者接受了RT。89.6%的患者实现了完全或部分疼痛缓解，58.6%的患者神经症状得到缓解。血红蛋白（Hb）、白细胞（WBC）、血小板计数（PLT）、骨髓浸润、血清钙（Ca）、肌酐、白蛋白、CRP、LDH、β2 - 微球蛋白水平在RT前后无显著变化。接受RT的患者中位生存期为32个月（范围30 - 34个月），未接受RT的患者中位生存期为33个月（范围28 - 36个月）（p>0.05）。接受2×8 Gy方案治疗的患者中位生存期为32个月（范围27 - 37个月），接受5×4 Gy方案治疗的患者中位生存期为34个月（范围25 - 39个月）（p>0.05）。
RT是缓解椎体和非椎体骨折骨痛以及减少髓外病变的非常有效的方法，但不影响MM患者的生存。
