König Laila, Herfarth Klaus
Abteilung RadioOnkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
Radiologe. 2022 Jan;62(1):30-34. doi: 10.1007/s00117-021-00935-y. Epub 2021 Nov 11.
Treatment options for patients with solitary plasmacytoma (SP) or multiple myeloma (MM) should be discussed in an interdisciplinary context. This systematic review focuses on the importance of radiotherapy in MM and SP.
Summary of local radio-oncological treatment options for patients with SP and MM.
Based on a systematic literature search, the current evidence on the topic was analyzed and summarized.
Patients with SP should be primarily treated with radiotherapy with or without surgery. Irradiation concepts may vary depending on risk factors and manifestation (solitary bone plasmacytoma vs. solitary extramedullary plasmacytoma). Although local control rates are high after radiotherapy, progression to multiple myeloma frequently occurs. In patients with MM, radiation is mainly used in palliative settings for pain relief, prevention of fractures or in patients who suffer from neurological symptoms due to spinal cord compression. Irradiation dose and fractionation should be selected based on treatment indication and general condition of the patient.
Although most patients receive systemic treatment at initial diagnosis, approximately 40% of patients with MM will require radiation during the course of their disease. While radiation is mainly used for palliation in patients with MM, it represents the primary and curative treatment option in patients with SP.
孤立性浆细胞瘤（SP）或多发性骨髓瘤（MM）患者的治疗方案应在多学科背景下进行讨论。本系统评价聚焦于放射治疗在MM和SP中的重要性。
总结SP和MM患者的局部放射肿瘤学治疗方案。
基于系统的文献检索，对该主题的现有证据进行分析和总结。
SP患者应以放疗为主，可联合或不联合手术。放疗方案可能因风险因素和表现形式（孤立性骨浆细胞瘤与孤立性髓外浆细胞瘤）而异。虽然放疗后的局部控制率较高，但多发性骨髓瘤的进展经常发生。在MM患者中，放疗主要用于姑息治疗以缓解疼痛、预防骨折或用于因脊髓压迫而出现神经症状的患者。应根据治疗指征和患者的一般状况选择放疗剂量和分割方式。
虽然大多数患者在初诊时接受全身治疗，但约40%的MM患者在疾病过程中需要放疗。放疗在MM患者中主要用于姑息治疗，而在SP患者中则是主要的根治性治疗选择。
