Oertel Michael, Schlusemann Tom, Shumilov Evgenii, Reinartz Gabriele, Bremer Anne, Rehn Stephan, Lenz Georg, Khandanpour Cyrus, Eich Hans Theodor
Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Cancers (Basel). 2023 May 25;15(11):2909. doi: 10.3390/cancers15112909.
Radiotherapy (RT) is an established treatment modality in the management of patients with multiple myeloma (MM), aiming at analgesia and stabilization of osteolytic lesions. As a multifocal disease, the combined use of RT, systemic chemotherapy, and targeted therapy (ST) is pivotal to achieve better disease control. However, adding RT to ST may lead to increased toxicity. The aim of this study was to evaluate the tolerability of ST given concurrently with RT. Overall, 82 patients treated at our hematological center with a median follow-up of 60 months from initial diagnosis and 46.5 months from the start of RT were evaluated retrospectively. Toxicities were recorded from 30 days before RT up to 90 days after RT. 54 patients (65.9%) developed at least one non-hematological toxicity, with 50 patients (61.0%) showing low-grade (grade I or II) and 14 patients (17.1%) revealing high-grade (grade III and IV) toxicities. Hematological toxicities were documented in 50 patients (61.0%) before RT, 60 patients (73.2%) during RT, and 67 patients (81.7%) following RT. After RT, patients who had received ST during RT showed a significant increase in high-grade hematological toxicities ( = 0.018). In summary, RT can be safely implemented into modern treatment regimens for MM, but stringent monitoring of potential toxicities even after completion of RT has to be ensured.
放射治疗（RT）是多发性骨髓瘤（MM）患者治疗中的一种既定治疗方式，旨在实现止痛和稳定溶骨性病变。作为一种多灶性疾病，联合使用RT、全身化疗和靶向治疗（ST）对于实现更好的疾病控制至关重要。然而，在ST基础上加用RT可能会导致毒性增加。本研究的目的是评估与RT同时进行的ST的耐受性。总体而言，对在我们血液学中心接受治疗的82例患者进行了回顾性评估，从初始诊断起的中位随访时间为60个月，从RT开始起为46.5个月。记录从RT前30天至RT后90天的毒性反应。54例患者（65.9%）发生了至少一种非血液学毒性反应，其中50例患者（61.0%）表现为低级别（I级或II级）毒性反应，14例患者（17.1%）表现为高级别（III级和IV级）毒性反应。RT前、RT期间和RT后分别有50例患者（61.0%）、60例患者（73.2%）和67例患者（81.7%）记录到血液学毒性反应。RT后，在RT期间接受ST的患者高级别血液学毒性反应显著增加（P = 0.018）。总之，RT可以安全地纳入MM的现代治疗方案中，但即使在RT完成后也必须确保对潜在毒性进行严格监测。
