Mayr N A, Wen B C, Hussey D H, Burns C P, Staples J J, Doornbos J F, Vigliotti A P
Department of Radiology, University of Iowa College of Medicine, Iowa City 52242-1059.
Radiother Oncol. 1990 Apr;17(4):293-303. doi: 10.1016/0167-8140(90)90003-f.
Between 1960 and 1985, 30 patients with solitary plasmacytomas were treated with radiotherapy at the University of Iowa: 13 patients with extramedullary plasmacytomas (EMP) and 17 with solitary plasmacytomas of bone (SPB). The local control rates were 92% for patients with EMP and 88% for those with SPB. Two of nine patients (22%) with EMP treated to the primary tumor only developed regional lymph node metastasis, indicating the need for elective irradiation of this area. The most common pattern of failure in both groups was progression to multiple myeloma. This occurred in 23% of the patients with EMP and 53% of those with SPB. The time course of progression to multiple myeloma differed for the two groups. All of those who progressed to multiple myeloma in the EMP group did so within 2 years, whereas a significant number of those in the SPB group progressed more than 5 years after initial therapy. None of five patients who received adjuvant chemotherapy in the SPB group progressed to multiple myeloma, compared to 75% (9/12) of the patients who did not receive chemotherapy.
1960年至1985年间，爱荷华大学对30例孤立性浆细胞瘤患者进行了放射治疗：13例为髓外浆细胞瘤（EMP），17例为骨孤立性浆细胞瘤（SPB）。EMP患者的局部控制率为92%，SPB患者为88%。仅对原发肿瘤进行治疗的9例EMP患者中有2例（22%）发生了区域淋巴结转移，这表明该区域需要进行选择性照射。两组最常见的失败模式是进展为多发性骨髓瘤。EMP患者中有23%发生这种情况，SPB患者中有53%发生这种情况。两组进展为多发性骨髓瘤的时间进程不同。EMP组中所有进展为多发性骨髓瘤的患者均在2年内发生，而SPB组中有相当数量的患者在初始治疗5年后进展。SPB组中接受辅助化疗的5例患者均未进展为多发性骨髓瘤，而未接受化疗的患者中有75%（9/12）进展为多发性骨髓瘤。
