Outcomes and patterns of failure in solitary plasmacytoma: A multicenter Rare Cancer Network study of 258 patients

Ozşahin, Mahmut; Tsang, Richard W.; Poortmans, Philip; Belkacémi, Yazid; Bolla, M.; Dinçbaş, Fazilet Öner; Landmann, Christine; Castelain, B.; Buijsen, Jeroen; Curschmann, Jürgen; Kadish, Sidney P.; Kowalczyk, Anna; Anacak, Yavuz; Hammer, J.; Nguyen, Tan Dat; Studer, Gabriela; Cooper, R.; Şengöz, Meriç; Scandolaro, Luciano; Zouhair, Abderrahim

doi:10.1016/j.ijrobp.2005.06.039

Cited by 222 publications

(253 citation statements)

References 30 publications

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“…[8][9][10][11] We also demonstrated a relation between the presence of myeloma protein at presentation and the risk of progression to myeloma, which agrees with our previously published data as well as others on the correlation between persistence of myeloma protein after radiation and the development of myeloma. 1,12 Dingli et al 13 also reported on the value a persistent serum protein level 5 g/L as a risk factor for progression along with an abnormal serum immunoglobulin-free light chain ratio at diagnosis.…”

Section: Discussionsupporting

confidence: 92%

“…However, a multicenter Rare Cancer Network study of 258 patients with SP and a Princess Margaret Hospital series of 46 patients produced no evidence of improvement in local control with radiation doses >30 to 35 Gy. 8,9 We could not demonstrate a significant association between tumor size and local control, but this may have been confounded by 2 factors. First, the maximum tumor size was not recorded for 23% of the patients in this series.…”

Section: Discussionmentioning

confidence: 69%

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Solitary plasmacytomas

Reed

Shah

Medeiros

et al. 2011

Cancer

100

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BACKGROUND:The objective of this study was to review the outcome of patients with solitary plasmacytoma (SP) after definitive radiation therapy. METHODS: The authors retrospectively reviewed 84 patients with SP who were diagnosed and treated at The University of Texas MD Anderson Cancer Center during 1988 to 2008. The impact of tumor anatomic site, tumor size, and the presence of serum and urinary paraprotein at diagnosis was assessed on local control, survival, and the risk of developing multiple myeloma (MM). RESULTS: Fifty-nine patients (70%) had bone SP, and 25 patients (30%) had extramedullary SP. Serum paraprotein was present in 39 patients (46%). The median radiation dose was 45 grays (Gy) (range, 36-53.4 Gy). Local control was achieved in 77 patients (92%). Neither radiation dose nor tumor size predicted local control. The 5-year rate of progression to MM was 47% and was higher for patients with bone SP (56% vs 30% for extramedullary SP; P ¼ .021), and patients who had serum paraprotein detected at diagnosis (60% vs 39%; P ¼ .016). On univariate analysis, patients aged <60 years and men had higher rates of progression to MM, although the differences were not significant (P ¼ .048 and P ¼ .29, respectively). Multivariate analysis revealed that bone location and serum protein at diagnosis were associated statistically with progression to MM. The 5-year overall survival rate for the entire patient cohort was 78%, and no difference was observed between patients who had bone SP versus extramedullary SP (76% vs 85%, respectively; P ¼ .274). CONCLUSIONS: The current results indicated that definitive radiation therapy for SP can provide excellent local control. Progression to MM remains the main problem and is more common among patients with bone SP and those who have serum paraprotein detected at diagnosis. Cancer 2011;117:4468-

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 69%

Solitary plasmacytomas

Reed

Shah

Medeiros

et al. 2011

Cancer

100

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“…In agreement with our findings, Tsang et al reported no higher risk of local recurrence for doses <35 Gy [7] and Oszahin et al described no dose-dependence of local control for doses >30 Gy [4]. In contrast, Mendenhall et al found that doses >40 Gy resulted in 94% local control of SBP compared to 69% after <40 Gy [14].…”

Section: Influence Of Dosesupporting

confidence: 92%

“…Data published so far are inconsistent: Significantly different OS rates were found by Ozsahin et al, who described 10-year overall survival rates of 72% for EP and 52% for SBP (p=0.04) [4], and Tsang et al, who reported 8-year overall survival rates of 70% or 33%, respectively (p=0.023). In contrast, neither Bolek et al [12] nor Jyothirmay et al [13] could detect a significant difference in OS.…”

Section: Overall Survivalmentioning

confidence: 86%

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Radiotherapy of solitary plasmacytoma

et al. 2011

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International audienceSolitary plasmacytoma of the bone (SBP) or extramedullary plasmacytoma (EP) are rare neoplasms amenable to local radiotherapy. In this retrospective analysis, we report the University Heidelberg experience in the treatment of solitary plasmacytoma. From 1995 to 2008, 18 patients were treated with local radiotherapy. Ten patients suffered from SBP, eight patients showed a single extramedullary lesion. Local radiotherapy with a median dose of 45 Gy yielded excellent local control with only one patient suffering from local relapse. SBP and EP had significantly different 5-year multiple myeloma-free survival rates of 36.8% and 86.7%, respectively. However, no significant difference in overall survival could be detected. Radiotherapy can achieve excellent local control of solitary plasmacytoma. Progression to multiple myeloma, especially in the case of SBP, remains to be addressed by further studies

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Radiotherapy vs Surgery for Survival and Locoregional Control of Head and Neck Extramedullary Plasmacytoma

Vasudevan,

Sayed,

Kapartiwar

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceThere are significant gaps in the literature pertaining to the locoregional control and survival rates of extramedullary plasmacytoma (EMP) with respect to various treatment approaches.ObjectiveTo systematically evaluate the differences in radiotherapy and surgical outcomes in EMP.Data SourcesDatabases including PubMed, Scopus, Web of Science, Embase, and ScienceDirect were systematically searched from their inception up to November 2023.Study SelectionArticles reporting radiotherapy and surgical outcomes of head and neck EMP were included.Data Extraction and SynthesisA random-effects model for meta-analysis was used to obtain pooled estimates and calculate hazard ratios for survival and odds ratios for recurrence and progression of EMP.Main Outcomes and MeasuresSurvival, tumor control, and progression rates to multiple myeloma (MM) between radiation therapy and surgery for EMP of the head and neck.ResultsOf 742 included patients from 12 studies, 527 (71.0%) were male, and the median (IQR) age was 59.1 (53-62) years. A total of 505 patients (68.1%) received radiotherapy only, while 237 (31.9%) underwent surgery-only treatment for EMP. All included patients had an initial diagnosis of EMP without MM. Comparable trends were observed in overall survival and disease-free survival (DFS) rates at 2, 3, 5, and 10 years between patients with EMP treated with radiotherapy only and surgery only. Notably, there were no significant differences in recurrence rate (odds ratio, 0.65; 95% CI, 0.20-2.06) between radiotherapy-only and surgery-only treatment. However, radiotherapy-only treatment of EMP was associated with decreased odds of progression to MM compared with surgery (odds ratio, 0.4; 95% CI, 0.1-0.9). Sensitivity analysis revealed that the radiotherapy-only population had significantly better 5-year DFS (hazard ratio, 0.55; 95% CI, 0.31-0.96) compared with surgery-only treatment.Conclusions and RelevanceThis systematic review and meta-analysis provides evidence that patients with EMP receiving radiotherapy had significantly lower chances of progression to MM compared with surgery-only therapy. Additionally, radiotherapy had better 5-year DFS outcomes compared with surgery. Comparable outcomes in terms of overall survival rates, recurrence, and mortality rates were noted between radiotherapy-only and surgery-only EMP treatment groups.

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Outcomes and patterns of failure in solitary plasmacytoma: A multicenter Rare Cancer Network study of 258 patients

Cited by 222 publications

References 30 publications

Solitary plasmacytomas

Solitary plasmacytomas

Radiotherapy of solitary plasmacytoma

Radiotherapy vs Surgery for Survival and Locoregional Control of Head and Neck Extramedullary Plasmacytoma

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