Schmaus M C, Neuhof D
Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland,
Radiologe. 2014 Jun;54(6):551-5. doi: 10.1007/s00117-013-2630-2.
Solitary plasmacytoma and multiple myeloma require a differentiated radiotherapy. The irradiation for plasmacytoma with an adequate total dose (medullary 40-50 Gy or extramedullary 50-60 Gy) leads to a high degree of local control with a low rate of side effects. In cases of multiple myeloma radiotherapy will achieve effective palliation, both in terms of recalcification as well as reduction of neurological symptoms and analgesia. In terms of analgesia the rule is the higher the single dose fraction the faster the reduction of pain. As part of a conditioning treatment prior to stem cell transplantation radiotherapy contributes to the establishment of a graft versus myeloma effect (GVM).
孤立性浆细胞瘤和多发性骨髓瘤需要进行个体化放疗。对浆细胞瘤进行照射时给予足够的总剂量(髓内40 - 50 Gy或髓外50 - 60 Gy)可实现高度的局部控制,且副作用发生率低。在多发性骨髓瘤病例中,放疗在骨再钙化、减轻神经症状和镇痛方面都能实现有效的姑息治疗。就镇痛而言,一般规律是单次剂量分割越高,疼痛缓解越快。作为干细胞移植前预处理治疗的一部分,放疗有助于建立移植物抗骨髓瘤效应(GVM)。