骨事件对孤立性骨浆细胞瘤生存的影响。
Impact of bone events on survival in solitary bone plasmacytoma.
作者信息
Mauro Geovanne Pedro, Neffá Pedro Pereira, Villar Rosangela Correa, Martinez Gracia Aparecida, Carvalho Heloísa de Andrade
机构信息
Department of Radiology and Oncology - Radiotherapy - Faculdade de Medicina da Universidade de São Paulo. Avenida Doutor Arnaldo, 155 - Cerqueira César, 01255-000 Sao Paulo - SP, Brazil.
Department of Hematology, Instituto do Câncer do Estado de São Paulo (ICESP) and Medical School of Sao Paulo University, Brazil.
出版信息
Rep Pract Oncol Radiother. 2020 May-Jun;25(3):389-395. doi: 10.1016/j.rpor.2020.04.002. Epub 2020 Apr 12.
BACKGROUND
Although much studied in multiple myeloma, bone events (BE) can also cause important morbidity in bone plasmacytoma patients. To our knowledge, the effect of BE on overall survival (OS) and progression to multiple myeloma free-survival (MPFS) also has never been studied.
PATIENTS AND METHODS
Fifty-nine patients treated from 2008 to 2017 were retrospectively assessed. All patients had histological proof of disease and were treated with radical radiotherapy (RT). Available clinical information for at least 6 months follow-up or until death had to be available. BE were described as one of the following events in the index bone: fractures, osteomyelitis, chronic pain, surgery or loss of limb function after RT.
RESULTS
Mean age at diagnosis was 57.3 years (18-80); most male (67.8%). Mean OS, bone event free-survival (BEFS), local progression-free survival (LPFS) and MPFS were 41, 36, 37 and 19 months, respectively. There were 15 deaths. BEFS (p = 0.008) and age>55y (p = 0.044) were associated with MPFS. Only BEFS correlated with OS (p = 0.029). BE was independently associated with both MPFS and OS in multivariate analysis.
CONCLUSION
BE and survival end-points were correlated. BE should be investigated in prospective trials.
背景
尽管在多发性骨髓瘤中已对骨事件（BE）进行了大量研究，但骨浆细胞瘤患者中的骨事件也可导致严重的发病率。据我们所知，骨事件对总生存期（OS）和进展为无多发性骨髓瘤生存期（MPFS）的影响也从未被研究过。
患者与方法
对2008年至2017年治疗的59例患者进行回顾性评估。所有患者均有疾病的组织学证据，并接受了根治性放疗（RT）。必须有至少6个月随访或直至死亡的可用临床信息。骨事件被描述为指数骨中的以下事件之一：骨折、骨髓炎、慢性疼痛、放疗后手术或肢体功能丧失。
结果
诊断时的平均年龄为57.3岁（18 - 80岁）；大多数为男性（67.8%）。平均总生存期、无骨事件生存期（BEFS）、局部无进展生存期（LPFS）和无多发性骨髓瘤生存期（MPFS）分别为41个月、36个月、37个月和19个月。有15例死亡。无骨事件生存期（p = 0.008）和年龄>55岁（p = 0.044）与无多发性骨髓瘤生存期相关。只有无骨事件生存期与总生存期相关（p = 0.029）。在多变量分析中，骨事件与无多发性骨髓瘤生存期和总生存期均独立相关。
结论
骨事件与生存终点相关。应在前瞻性试验中对骨事件进行研究。
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