Rostom A Y, O'Cathail S M, Folkes A
Br J Haematol. 1984 Nov;58(3):423-31. doi: 10.1111/j.1365-2141.1984.tb03989.x.
Nineteen patients with relapsed or resistant multiple myeloma were treated with sequential half-body irradiation (12) and half-body irradiation only (seven). This treatment proved acceptable to the majority of patients and required one night's stay in hospital. Gastro-intestinal toxicity was transient and self limiting. Haematological toxicity was acceptable and recovery was complete in all but two of the 19 patients following half-body irradiation. However, only six of the 12 patients who subsequently had the remaining half irradiated completely recovered. Blood transfusions were required to correct anaemia in six patients, a platelet transfusion was given to one and a further patient required both platelet and blood transfusions. We observed no serious haematological complications. Six of the 13 patients who received upper half-body irradiation of probable chest infection, while one patient of the six who received lower half-body irradiation died of this complication. Some of the seven deaths may have been due to radiation pneumonitis. Two patients developed brain secondaries, which is a very rare occurrence in this disease. This may indicate a change in the natural history of myeloma produced by this new treatment. Subjective improvement was observed in 17 patients and relief of pain usually occurred within the first 24 h. Objective responses were noted in six patients. The median survival for all patients was 6 months with five patients alive 11-28 months at the time of this report. This treatment compares favourably to second line chemotherapy. It is perhaps more economical and better tolerated by patients. Further assessment in a larger number of patients with either untreated or relapsed disease is warranted.
19例复发或难治性多发性骨髓瘤患者接受了序贯半身照射（12例）和仅半身照射（7例）治疗。该治疗方法被大多数患者接受，且只需住院一晚。胃肠道毒性是短暂的，可自行缓解。血液学毒性是可接受的，19例患者中除2例之外，其余患者在半身照射后均完全恢复。然而，随后接受另一半照射的12例患者中只有6例完全康复。6例患者需要输血以纠正贫血，1例患者接受了血小板输注，另有1例患者既需要血小板输注也需要输血。我们未观察到严重的血液学并发症。接受上半身照射的13例患者中有6例可能发生了胸部感染，而接受下半身照射的6例患者中有1例死于该并发症。7例死亡中的一些可能是由于放射性肺炎。2例患者出现脑部转移，这在该疾病中非常罕见。这可能表明这种新治疗方法改变了骨髓瘤的自然病程。17例患者出现主观改善，疼痛缓解通常发生在最初24小时内。6例患者出现客观缓解。所有患者的中位生存期为6个月，在本报告时，有5例患者存活11 - 28个月。这种治疗方法与二线化疗相比具有优势。它可能更经济，且患者耐受性更好。有必要对更多未治疗或复发疾病的患者进行进一步评估。
