Radiation Oncology Department, Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
Health Outcomes & Behavior Department, Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
Acta Oncol. 2020 Aug;59(8):983-987. doi: 10.1080/0284186X.2020.1772499. Epub 2020 Jun 4.
Radiation therapy (RT) has been widely used for palliation in multiple myeloma. However, no data exist on symptom assessment and patient-reported outcomes regarding the efficacy of RT in this disease process. This study aims to demonstrate the impact of palliative RT on patient-reported symptoms in patients with multiple myeloma. Our Radiation Oncology and Supportive Care Medicine clinics established the use of a modified Edmonton Symptom Assessment Scale (ESAS) in 2015 assessing 12 symptom domains. All had ESAS data available from each encounter. Demographic and clinical data were retrospectively collected from an institutional data warehouse. We examined total and component survey scores for correlated data of patients during radiation treatment and patients not treated with radiation. Clinic records of 30 patients with multiple myeloma seen in the Radiation Oncology and Supportive Care clinics from 2015 to 2018 were retrieved. A total of 91 discrete surveys were collected (1183 data points). Twenty of these were collected from weekly visits from 12 patients receiving RT; the remainder were from new patient or follow up encounters. Odds ratios were lower with radiation therapy for total scores (OR 4.86, = .007), as well as several component scores. The use of palliative RT was associated with 5 times lower total symptom scores compared with nonuse. Similar beneficial results were found for several component scores. These patient-reported outcomes strongly suggest that providers should consider palliative radiation for symptomatic multiple myeloma patients. These data should be prospectively validated in a larger cohort of myeloma patients.
放射治疗（RT）已广泛用于多发性骨髓瘤的姑息治疗。然而，目前尚无关于 RT 在该疾病过程中缓解症状和患者报告结局的疗效数据。本研究旨在展示姑息性 RT 对多发性骨髓瘤患者报告症状的影响。我们的放射肿瘤学和支持性护理医学诊所于 2015 年建立了使用改良的埃德蒙顿症状评估量表（ESAS），评估 12 个症状领域。所有患者在每次就诊时都有 ESAS 数据可用。从机构数据仓库中回顾性收集人口统计学和临床数据。我们检查了在放射治疗期间和未接受放射治疗的患者的相关数据的总评分和成分评分。从 2015 年至 2018 年，从放射肿瘤学和支持性护理诊所共检索到 30 名多发性骨髓瘤患者的临床记录。共收集了 91 份离散的调查（1183 个数据点）。其中 20 份来自接受 RT 的 12 名患者的每周就诊；其余的来自新患者或随访就诊。对于总评分（OR 4.86， = .007）以及几个成分评分，放射治疗的比值比更低。与未使用相比，姑息性 RT 的使用与总症状评分降低 5 倍相关。几个成分评分也有类似的有益结果。这些患者报告的结果强烈表明，提供者应考虑为有症状的多发性骨髓瘤患者提供姑息性放疗。这些数据应在更大的骨髓瘤患者队列中进行前瞻性验证。
