Jacobs P, le Roux I, King H S
University of Cape Town Leukaemia Centre, South Africa.
Am J Clin Oncol. 1988 Apr;11(2):104-9. doi: 10.1097/00000421-198804000-00003.
Fifteen patients with a median age of 58 years, having multiple myeloma resistant to conventional combinations of cytotoxic drugs, received sequential half-body irradiation as salvage therapy. Response was obtained in 53% (n = 8: group 1); this was objective in 40% (n = 6), being defined as 50% or greater reduction in paraprotein, clearance of light chains from the urine, or an unequivocal decrease in tumor bulk on an adequate marrow trephine biopsy; a further 13% (n = 2) just failed to meet these criteria but nevertheless had excellent subjective response. Median survival was 24 months. No objective or subjective improvement occurred in 47% (n = 7: group 2); median transient survival was 4 months. Short-term toxicity was limited to transient nausea in 30% (n = 5) and protracted pancytopenia in about one-half of the patients (n = 7), who remain dependent on intermittent RBC transfusions. Morbidity is only moderate, and the response rate of 53% in refractory patients suggests that sequential half-body irradiation has a definite place in managing patients with end-stage disseminated myelomatosis.
15例中位年龄为58岁、对细胞毒性药物常规联合方案耐药的多发性骨髓瘤患者接受了序贯半身照射作为挽救治疗。53%（n = 8：第1组）的患者获得缓解；其中40%（n = 6）为客观缓解，定义为副蛋白减少50%或更多、尿轻链清除、或在充分的骨髓环钻活检中肿瘤体积明确减小；另外13%（n = 2）虽未达到这些标准，但有良好的主观缓解。中位生存期为24个月。47%（n = 7：第2组）的患者未出现客观或主观改善；中位短暂生存期为4个月。短期毒性仅限于30%（n = 5）的患者出现短暂恶心，约一半患者（n = 7）出现持续性全血细胞减少，这些患者仍依赖间歇性红细胞输血。发病率仅为中度，难治性患者53%的缓解率表明序贯半身照射在终末期播散性骨髓瘤患者的治疗中具有明确地位。
