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[孤立性骨浆细胞瘤:摩洛哥拉巴特穆罕默德五世军事教学医院放疗科的经验]

[Solitary bone plasmocytoma: Experience from the radiotherapy department at Mohammed-V military teaching hospital in Rabat (Morocco)].

作者信息

Hadadi Khalid, Hommadi M, Belemlih Maroa, Zaghba Noha, Maghous Abdelhak, Marnouch El-Amin, Saghir K A, Elmarjany Mohamed, Sifat Hassan, Oukabli Mohamed, Mansouri Hamid

机构信息

Service de radiothérapie, hôpital militaire d'instruction Mohammed-V, Rabat, Maroc.

Service de radiothérapie, Institut national d'oncologie, Rabat, Maroc.

出版信息

Cancer Radiother. 2019 Dec;23(8):867-873. doi: 10.1016/j.canrad.2019.06.013. Epub 2019 Oct 31.

Abstract

PURPOSE

The primary objective was to determine in our department the progression-free survival rate of patients with solitary bone plasmocytoma and secondarily to evaluate its diagnostic, therapeutic and evolutionary aspects.

PATIENTS AND METHODS

This is a retrospective review of 12 patients monitored and treated in the radiotherapy department of the Mohammed-V military medical teaching hospital in Rabat for a solitary bone plasmocytoma between January 2012 and December 2018. The average age of our patients were 53.8 years old (range: 31-72 years old). Pain was the most common telltale sign. The site of the lesions was spinal in four cases, iliac in four cases, mandibular, ribal, humeral and at the level of the astragalus in one case respectively. All patients received radiotherapy. This irradiation was delivered alone in 60% of cases or associated with surgery in 40% of cases. The average dose of radiotherapy was 47.3Gy (range: 45 to 50.4Gy) and this was delivered by a modulated volumetric arc therapy technique in ten patients and conformal tridimensional radiotherapy in two patients.

RESULTS

Local control, defined by stability or radiological regression, was obtained in ten patients and four patients progressed to multiple myeloma, two of whom died. The average duration of follow-up was 51 months.

CONCLUSION

Radiation therapy is the standard treatment for solitary bone plasmocytoma. It ensures good local control in 90% of cases. The prognosis is affected by progression to multiple myeloma, which justifies rigorous monitoring after treatment and suggests a reflection on the exact place of chemotherapy.

摘要

目的

本研究的主要目的是确定我院孤立性骨浆细胞瘤患者的无进展生存率,其次是评估其诊断、治疗及演变情况。

患者与方法

这是一项对2012年1月至2018年12月期间在拉巴特穆罕默德五世军事医学教学医院放疗科接受监测和治疗的12例孤立性骨浆细胞瘤患者的回顾性研究。我们患者的平均年龄为53.8岁(范围:31 - 72岁)。疼痛是最常见的症状。病变部位分别为4例在脊柱,4例在髂骨,1例在下颌骨、肋骨、肱骨和距骨水平。所有患者均接受了放疗。60%的病例单独进行放疗,40%的病例放疗联合手术。放疗的平均剂量为47.3Gy(范围:45至50.4Gy),其中10例患者采用容积调强弧形放疗技术,2例患者采用适形三维放疗。

结果

10例患者实现了局部控制,定义为病情稳定或影像学退缩,4例患者进展为多发性骨髓瘤,其中2例死亡。平均随访时间为51个月。

结论

放射治疗是孤立性骨浆细胞瘤的标准治疗方法。它在90%的病例中能确保良好的局部控制。预后受进展为多发性骨髓瘤的影响,这证明了治疗后进行严格监测的合理性,并提示对化疗的确切作用进行思考。

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