Radiation therapy for the palliation of multiple myeloma

Leigh, Bryan R.; Kurtts, Terry A.; Mack, C.; Matzner, Monika; Shimm, David S.

doi:10.1016/0360-3016(93)90308-i

Cited by 84 publications

(33 citation statements)

References 11 publications

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“…[5] and Mose et al. [11] concurrent chemotherapy had a significant impact on a positive response to radiotherapy, but our and other studies did not show this relationship [4, 9]. Lack of correlation with chemotherapy may be because chemotherapy effectively reduces tumour bulk but its effect on local symptoms is not always sufficient.…”

Section: Discussionmentioning

confidence: 60%

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Single vs. multiple fraction regimens for palliative radiotherapy treatment of multiple myeloma

et al. 2017

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PurposeTo compare the impact of a single fraction (8 Gy × 1 fraction) and multifraction (3 Gy × 10 fractions) radiotherapy regimens on pain relief, recalcification and the quality of life (QoL) in patients with bone destructions due to multiple myeloma (MM).Patients and methodsIn all, 101 patients were included in a randomised prospective clinical trial: 58 patients were included in the control arm (3 Gy × 10 fractions) and 43 patients into the experimental arm (8 Gy × 1 fraction). The response rate was defined according to the International Consensus on Palliative Radiotherapy criteria. Recalcification was evaluated with radiographs. QoL questionnaires were completed before and 4 weeks after treatment.ResultsPain relief was obtained in 81/101 patients (80.2%): complete response in 56 (69%) and partial in 25 patients (30.9%). No significant differences were observed in analgesic response between the groups. Significant factors for pain relief were female gender, age under 65, IgG MM type, presence of recalcification at the irradiated site. Recalcification was found in 32/101 patients (33.7%): complete in 17 (53.2%) and partial in 15 (46.2%). No significant differences were observed in recalcification between the groups. Significant factors for recalcification were Karnofsky index ≥ 60%, haemoglobin level ≤ 80 g/dl, MM stage II and analgesic response at the irradiated site. The QoL after radiotherapy was improved in the control group.ConclusionThe same analgesic and recalcification response was observed using two different radiotherapy regimens. Higher doses should be used to achieve a better QoL.

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Section: Discussionmentioning

confidence: 60%

“…Some studies did not find a significant difference between the dose of radiation and pain reduction [4, 7, 9, 11]; however, Adamietz et al. [5] and Minova et al.…”

Section: Discussionmentioning

confidence: 99%

Single vs. multiple fraction regimens for palliative radiotherapy treatment of multiple myeloma

et al. 2017

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“…Local radiotherapy is effective for treating pain caused by bone lesions in multiple myeloma [78,79]. Approximately 70% of myeloma patients with bone disease receive radiation therapy during the course of their illness; however, data on radiotherapy after the introduction of novel agents are lacking.…”

Section: Clinical Management Of Multiple Myeloma Bone Diseasementioning

confidence: 99%

Bone disease in multiple myeloma and precursor disease: novel diagnostic approaches and implications on clinical management

Kristinsson¹,

Minter²,

Korde³

et al. 2011

Expert Review of Molecular Diagnostics

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The manifestations of bone involvement in patients with multiple myeloma (MM) can have devastating clinical effects and increase mortality. Recent studies demonstrate that patients with the precursor conditions smoldering MM (SMM) and monoclonal gammopathy of undetermined significance (MGUS) show evidence of bone disease and increased risk of fractures. The understanding of the pathogenesis of bone disease in MM has expanded in recent years. The traditional skeletal survey will probably be replaced by newer and more sensitive imaging techniques, which may have a prognostic impact and change our definition of MGUS and SMM. Bisphosphonates are recommended to prevent skeletal events in patients with MM, and have also been studied in SMM and MGUS. This article summarizes the current knowledge of bone disease in plasma cell disorders, and discusses the current standard and future role of novel imaging techniques, as well as the evidence and current guidelines for bisphosphonates in MM, SMM and MGUS.

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“…(50) For what concerns local measures, radiotherapy is effective for bone pain relief. (51,52) Vertebroplasty is another effective method against local pain. It strengthens the bone, but still does not restore vertebral height.…”

Section: Bone Diseasementioning

confidence: 99%

Management of older patients with multiple myeloma

Gay

Palumbo

2011

Blood Reviews

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For many years, the oral combination melphalan-prednisone (MP) has been considered the standard of care for patients with multiple myeloma (MM) not eligible for autologous stem cell transplantation. In the era of novel agents, the introduction of immunomodulatory drugs and proteasome inhibitors has challenged the role of MP and lead to new standards of care for this disease. Five randomized phase III studies compared the traditional MP with the MP plus thalidomide (MPT). All these studies showed a prolonged time to progression (TTP) with the 3-drug combination. However, in only two of these trials this advantage translated into an improvement in overall survival (OS). In another randomized trial, MP plus bortezomib (VMP) was correlated with an increase in both TTP and OS compared with MP. Preliminary data showed the

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Radiation therapy for the palliation of multiple myeloma

Cited by 84 publications

References 11 publications

Single vs. multiple fraction regimens for palliative radiotherapy treatment of multiple myeloma

Single vs. multiple fraction regimens for palliative radiotherapy treatment of multiple myeloma

Bone disease in multiple myeloma and precursor disease: novel diagnostic approaches and implications on clinical management

Management of older patients with multiple myeloma

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