A retrospective review is reported of 128 patients presenting with multiple myeloma and 16 patients presenting with solitary plasmacytoma. Ninety-one percent of 116 evaluable patients treated for palliation of painful bone disease received some degree of subjective pain relief. The radiation dose most frequently prescribed was between 1500 and 2000 rad. Of the 278 ports treated, only 17 (6.1%) were re-treated to the same area at a later date. There was no increase in incidence of re-treatment with lower radiation doses. Ten of the 13 patients treated for a solitary plasmacytoma with a minumum follow-up period of three years have local tumor control. The median survival in the solitary plasmacytomas is five and one-half years. Data from the literature on 27 additional solitary plasmacytomas combined with our data suggest an improved local control and a decrease in dissemination with doses greater than 5000 rad. It is concluded that low doses of radiation are usually adequate to treat painful bone lesions of multiple myeloma and doses of 5000-6500 rad in six to seven weeks are recommended for solitary plasmacytomas.
The characteristics of 79 patients with malignant tumors of the nasopharynx are correlated with their survival. A modification to the TNM classification is presented, as well as a definition of the different pathologic types of tumors. Twenty‐four out of 70 patients survived 5 years tumor free (34%). However, 4 of these surviving patients developed recurrent tumor and/or distant metastasis at a later date. Early lesions, without neurologic findings, bony destruction, or large metastatic lymph nodes, had a better prognosis. This was true also for the lymphoepithelioma and the well‐differentiated squamous carcinoma. Over 40% of the patients that failed developed local recurrence, even with doses in the range of 6000 rads. Small fields used before 1958 were found to correlate with a higher local failure rate, probably due to geographical miss resulting in marginal recurrences. Elective irradiation of the neck resulted in a high degree of sterilization of metastatic tumor in die lymph nodes. From the experience in 7 patients, it was concluded that radical neck dissection, after a full course of radiation therapy, adds nothing to the treatment of these patients and is associated with a significant number of complications.
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