Singer C R, Tobias J S, Giles F, Rudd G N, Blackman G M, Richards J D
Department of Haematiology, University College Hospital, London, England, United Kingdom.
Cancer. 1989 Jun 15;63(12):2446-51. doi: 10.1002/1097-0142(19890615)63:12<2446::aid-cncr2820631214>3.0.co;2-w.
The authors report the results of treatment of 41 patients with melphalan-resistant multiple myeloma using single half-body irradiation (HBI) or double half-body irradiation (DHBI). Patients were grouped using prognostic classification reported by the Medical Research Council. Patients in group I and II showed the best response to therapy with reduction in serum of urinary paraprotein and improvement in symptoms, most notably a marked reduction in bone pain. In these groups five patients have survived over 2 years after therapy. The therapeutic response appeared better in those patients who received DHBI as opposed to those whom treated with single HBI. Patients in group III did not achieve prolonged survival but effective relief of bone pain was a consistent finding in these patients also. Thus HBI represents an alternative to combination chemotherapy as second-line treatment of patients with melphalan-resistant multiple myeloma. A comparative study of HBI versus combination chemotherapy is now indicated to establish which therapeutic approach is most effective.
作者报告了使用单次半身照射（HBI）或双次半身照射（DHBI）治疗41例美法仑耐药性多发性骨髓瘤患者的结果。患者采用医学研究委员会报告的预后分类进行分组。I组和II组患者对治疗反应最佳，尿副蛋白血清水平降低，症状改善，最显著的是骨痛明显减轻。在这些组中，有5名患者在治疗后存活超过2年。接受DHBI治疗的患者的治疗反应似乎比接受单次HBI治疗的患者更好。III组患者未实现长期生存，但这些患者也一致出现骨痛有效缓解的情况。因此，HBI可作为美法仑耐药性多发性骨髓瘤患者二线治疗的联合化疗替代方案。现在需要对HBI与联合化疗进行比较研究，以确定哪种治疗方法最有效。
