Greenberg P, Parker R G, Fu Y S, Abemayor E
Am J Clin Oncol. 1987 Jun;10(3):199-204. doi: 10.1097/00000421-198706000-00004.
Eleven patients with solitary plasmacytoma of bone (SPB) and six patients with extramedullary plasmacytoma (EMP) were treated at the UCLA Center for the Health Sciences. Primary treatment in 14 of 17 patients was with radiation, while three patients were irradiated for recurrent disease. Eleven patients with SPB were irradiated with dose of 32-55 Gy, with 10 of 11 patients receiving doses of 40-55 Gy. Local control was achieved in 10 of 11 patients with SPB. One patient died with metastatic disease with unknown local status. Six patients with EMP were irradiated with doses of 38-56 Gy. Of these patients, two were locally controlled; one patient failed locally; one patient died during treatment; one patient died with local disease at 85 months after multiple resections, chemotherapy, and two courses of irradiation; and one patient was lost to follow-up. Progression to multiple myeloma was seen in 5 of 11 patients with SPB and in none of six patients with EMP. For patients with SPB, we recommend treating the entire bone to 40 Gy, with a boost when feasible. Patients with EMP receive the same dose, including the lymph nodes in tumors at high risk for spread. Radical surgical resections appear to be unwarranted.
11例骨孤立性浆细胞瘤（SPB）患者和6例髓外浆细胞瘤（EMP）患者在加州大学洛杉矶分校健康科学中心接受了治疗。17例患者中有14例的初始治疗采用放疗，3例患者因疾病复发接受放疗。11例SPB患者接受了32 - 55 Gy的放疗剂量，11例患者中有10例接受了40 - 55 Gy的剂量。11例SPB患者中有10例实现了局部控制。1例患者死于转移性疾病，局部情况不明。6例EMP患者接受了38 - 56 Gy的放疗剂量。在这些患者中，2例实现了局部控制；1例局部治疗失败；1例患者在治疗期间死亡；1例患者在多次切除、化疗和两个疗程放疗后的85个月死于局部疾病；1例患者失访。11例SPB患者中有5例进展为多发性骨髓瘤，6例EMP患者中无一例进展。对于SPB患者，我们建议对整个骨骼给予40 Gy的照射，可行时进行增敏照射。EMP患者接受相同剂量的照射，包括对有高转移风险肿瘤的淋巴结进行照射。根治性手术切除似乎没有必要。
