Radiotherapy in the management of solitary extramedullary plasmacytoma

Chao, Michael; Gibbs, Peter; Wirth, Andrew; Quong, George; Guiney, Michael; Liew, Kuen Hoe

doi:10.1111/j.1445-5994.2005.00804.x

Cited by 93 publications

(70 citation statements)

References 26 publications

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“…reported in patients receiving surgery and/or RT [2,5,[21][22][23][24]. Moreover, a substantial proportion of patients are cured of their disease.…”

Section: Management Of Solitary Plasmacytomamentioning

confidence: 99%

Radiation therapy for the solitary plasmacytoma

Kocak

Ballerini²,

Zouhair³

et al. 2010

Turk J Hematol

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Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM), plasma-cell leukemias, solitary plasmacytomas (SP) of the bone (SPB), and extramedullary plasmacytomas (EMP). These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT). However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control. (Turk J Hematol 2010; 27: 57-61) Key words: Solitary plasmacytoma, radiotherapy, multiple myeloma, management Received: September 17, 2009 Accepted: March 3, 2010 ÖzetPlazma hücre malignitesi klasik olarak dört gruptur: multiple myelom (MM), plazma hücre lösemisi, kemik yerleşimli soliter plazmasitom (SPB) ve ekstrameduller yerleşimli plazmasitom (EMP). Lokalize plazma hücre malignitesini iskelet sistemi yerleşimli SP ve EMP oluşturur. Plazmasitoma birçok farklı şekilde tanımlanabilir. Çoğunlukla kemik iliğinde veya yumuşak dokuda plazma hücrelerinden oluşan bir kitle şeklinde görülür. Henüz, soliter plazmositomların MM'a dönüşümü arasindaki ilişki tam olarak tanımlanmamıştır. Soliter plazmositomlar, hem SPB hem de EMP için ana tedavi radyoterapidir. Ancak, SP için uygun tedavi dozu için ortak bir data yoktur. Lokal kontrol için optimal doz hastalığın yerine ve boyutuna bağlı olarak 30 ve 50 Gy arasında değişmektedir. Bu derlemede lokal kontrol için minimal RT dozu tanımlanmaya çalışılmıştır.(Turk J Hematol 2010; 27: 57-61) Anahtar kelimeler: Soliter plazmasitom, radyoterapi, multipl miyelom, tedavi yaklaşımı

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“…reported in patients receiving surgery and/or RT [2,5,[21][22][23][24]. Moreover, a substantial proportion of patients are cured of their disease.…”

Section: Management Of Solitary Plasmacytomamentioning

confidence: 99%

Radiation therapy for the solitary plasmacytoma

Kocak

Ballerini²,

Zouhair³

et al. 2010

Turk J Hematol

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“…Although local response to radiotherapy is very good [7][8][9][10] , about half of patients with SPs eventually develop a multiple myeloma [11][12][13][14][15][16][17] . Prescription doses used to irradiate this type of tumors are discussed in the literature.…”

Section: Discussionmentioning

confidence: 99%

Helical tomotherapy and systemic targeted therapies in solitary plasmacytoma: Pilot study

Wiazzane

Chargari²,

Plancher³

et al. 2013

WJR

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AIM:To assess the feasibility of the combination of helical tomotherapy ® (HT) and a concurrent systemic targeted therapy in patients with solitary plasmacytoma (SP) with the aim to decrease toxicity while improving therapeutic efficacy. METHODS:Six patients with biologically, histologically, and radiologically confirmed SP were treated using HT and a systemic targeted treatment concomitantly. Total dose was 40 Gy/20 fractions. Four patients received 4 cycles of concurrent lenalidomide-dexamethasone combination and two patients were treated with concomitant bortezomib-dexamethasone. All toxicities were described using the Common Terminology Criteria for Adverse Effects v3.0. RESULTS:Five patients had a bone tumor and one patient had an isolated pancreatic mass. Five patients presented with pain, one had neurologic symptoms related to medullary compression, which was treated by an emergency surgery. Median age was 59.5 years (range, 50-74 years). All patients had initial positron emission tomography-computed tomographys, three patients had total body bone magnetic resonance imaging examination, and three patients had computed tomodensitometry scans. The toxicity profile was excellent with no higher than grade 1 toxicity. Four of the six patients experienced a partial radiological response, four had complete response on positions emission tomography and 5/6 patients experienced a complete relief of their symptoms 4 mo after treatment. At a median follow-up of 18 mo, 5/6 patients were controlled clinically, radiologically, and biologically.CONCLUSION: Using HT, we could deliver a highly conformal irradiation concurrently with a molecularly targeted therapy. This association yielded in a high response rate and a low toxicity. A prospective study with longer follow-up will help determining the true benefit of such strategy.

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“…EMP is highly radiosensitive with excellent results (< 10% of local recurrences and about 50%-65% of patients remain free of disease for > 10 years) [13] . However, it is associated with a high morbidity particularly when used for large retroperitoneal tumors.…”

Section: Discussionmentioning

confidence: 99%