Bosch A, Frias Z
Department of Radiation Oncology, Oncologic Hospital, Puerto Rico Medical Center, Hato Rey.
Int J Radiat Oncol Biol Phys. 1988 Dec;15(6):1363-9. doi: 10.1016/0360-3016(88)90232-5.
Fifty-nine patients with multiple myeloma referred for treatment of painful bony lesions received irradiation to 95 local areas, and 16 of the 59 were irradiated using hemibody techniques. Pain relief was obtained in practically all of the irradiated regions. Most local areas were treated to doses of 3000 cGy in 10 to 15 fractions. Patients with generalized pain due to multiple site involvement were treated with single dose hemibody irradiation, to doses of 600 cGy to the upper hemibody, and of 800 cGy to the lower hemibody. This treatment was well tolerated and side effects minimal. Median survival from diagnosis was 30 months and the survival at 1, 3, and 5 years was 80%, 42%, and 12% respectively. Key articles on radiation therapy of multiple myeloma are reviewed and discussed. Since all patients eventually relapse after chemotherapy, the role of radiotherapy using present techniques should be fully evaluated and considered as an alternative in the primary treatment of multiple myeloma.
59例因多发性骨髓瘤骨痛性病变而转诊接受治疗的患者，其95个局部区域接受了放射治疗，其中59例中有16例采用半身照射技术。几乎所有接受照射的区域疼痛均得到缓解。大多数局部区域接受的剂量为3000 cGy，分10至15次给予。因多部位受累而出现全身疼痛的患者接受单次半身照射，上半身剂量为600 cGy，下半身剂量为800 cGy。该治疗耐受性良好，副作用极小。自诊断起的中位生存期为30个月，1年、3年和5年生存率分别为80%、42%和12%。对关于多发性骨髓瘤放射治疗的关键文章进行了综述和讨论。由于所有患者在化疗后最终都会复发，应充分评估并考虑采用当前技术进行放射治疗在多发性骨髓瘤初始治疗中的替代作用。
