Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy.
Clinical Research Development and Phase I Unit, ASST Spedali Civili Di Brescia, Brescia, Italy.
J Cancer Res Clin Oncol. 2021 Jun;147(6):1773-1779. doi: 10.1007/s00432-020-03452-y. Epub 2020 Nov 17.
Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells. Definitive RT can result in long-term local control of the SP. Due to the small number of patients and narrow range of doses, phase III randomized trials are lacking. The aim of this study is to further support the potential use of RT for the treatment of SP.
Clinical data of all patients treated for SP at our Institution between 1992 and 2018 were reviewed. A total of 42 consecutive patients were analyzed.
The median follow-up was 84.8 months. Radiation dose did not differ significantly as a function of sex, type of SP (solitary bone plasmacytoma or as extramedullary plasmacytoma), tumor size; conversely differs significantly as a function of age (p = 0.04). The 5y-OS and 10y-OS were, respectively, 96 and 91%. Local recurrences developed in 21.4% of patients (9/42). 16 patients progressed to MM (38.1%). The 5y-progression to MM free survival (PMFS) and the 10y-PMFS were, respectively, 68.6 and 61.9%.
Our data confirm that good results are achievable with RT to treat SP, but they don't allow defining a dose-effect correlation; therefore, it remains uncertain which is the most effective dose and whether lower doses can guarantee adequate disease control.
孤立性浆细胞瘤(SP)的特征是单个克隆浆细胞瘤肿块。明确的放疗可实现 SP 的长期局部控制。由于患者人数少且剂量范围窄,缺乏 III 期随机试验。本研究旨在进一步支持放疗治疗 SP 的潜在用途。
回顾了 1992 年至 2018 年期间在我们机构治疗 SP 的所有患者的临床数据。共分析了 42 例连续患者。
中位随访时间为 84.8 个月。辐射剂量与性别、SP 类型(孤立性骨浆细胞瘤或髓外浆细胞瘤)、肿瘤大小无关;但与年龄显著相关(p=0.04)。5y-OS 和 10y-OS 分别为 96%和 91%。21.4%(9/42)的患者出现局部复发。16 例患者进展为 MM(38.1%)。5y 无 MM 进展生存(PMFS)和 10y-PMFS 分别为 68.6%和 61.9%。
我们的数据证实,放疗治疗 SP 可获得良好的结果,但不能确定剂量效应关系;因此,尚不确定哪种剂量最有效,以及较低的剂量是否可以保证充分的疾病控制。