Radiotherapy of splenomegaly

Kříž, Jan; Micke, Oliver; Bruns, Frank; Haverkamp, Uwe; Mücke, Ralph; Schäfer, Ulrich; Seegenschmiedt, Heinrich; Müller, Rolf-Peter; Eich, Hans Theodor

doi:10.1007/s00066-011-2252-4

Cited by 21 publications

(10 citation statements)

References 21 publications

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“…Splenic irradiation is a well-established palliative treatment option in patients with lympho-and myeloproliferative malignancies presenting with symptomatic splenomegaly [1,8]. In addition, radiotherapy is known to be effective in a large variety of degenerative and hyperproliferative benign conditions [9].…”

Section: Discussionmentioning

confidence: 99%

“…For splenic irradiation in lympho-and myeloproliferative malignancies a large variation of different schedules is used with single doses from 0.1 to 2 Gy and total doses of 0.3–16 Gy and no consensus recommendations exist concerning total dose and fractionation regimes until now [1,13]. In our series we showed that a significant lower dose of 3.0 Gy is sufficient to achieve suitable pain relief and hematological response compared to higher doses (12 Gy and more) reported by Kenawi and Liu et al In addition, prescription of lower doses preserves the potential of re-irradiation in cases of treatment failure in this palliative setting, as it was seen in patient 3.…”

Section: Discussionmentioning

confidence: 99%

“…Splenic irradiation has been widely used in palliative treatment of symptomatic splenomegaly in patients with lymphoid and myeloid malignancies as reported currently by Kriz et al in a large cohort of patients using different fractionation regimens [1]. Apart from lymphoid and myeloid malignancies hypersplenism–characterized by painful splenomegaly and cytopenia–can also occur as a secondary phenomenon in a variety of benign disorders.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data

2014

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BackgroundTo show effectiveness of low-dose splenic irradiation in symptomatic congestive splenomegaly.MethodsFive patients were referred to our department for symptomatic congestive splenomegaly within three years. Primary diseases were autoimmune hepatitis with liver cirrhosis (n = 2), cystic fibrosis (n = 1), granulomatous liver disease (n = 1) and Werlhof disease with liver cirrhosis (n = 1). Mean age was 54 years (range: 36–67). Patients received splenic irradiation with a total dose of 3 Gy (single dose: 0.5 Gy). One patient was re-irradiated after long-term failure with the same treatment schedule.ResultsIn four patients long term relief of splenic pain could be observed during the follow-up time of median 20 (range: 2–36) months. Four patients showed haematological response after irradiation with an increase of erythrocytes, leucocytes and/or platelets. A slightly decrease in spleen size was found in two patients.ConclusionsLow-dose splenic irradiation in symptomatic congestive splenomegaly is feasible and perhaps as effective as in lympho-and myeloproliferative malignancies regarding pain relief and haematological response.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data

2014

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“…Weinman et al ’s review showed that spleen irradiation allowed relief of pain and abdominal discomfort with a response rate of 50%–90% [13]. Similar results were described by Krizetal, reporting pain relief in 74% of the 122 patients analysed [14]. Carolina de la Pinta et al presented five patients with symptomatic splenomegaly treated with low doses of radiation (median radiation doses 4.85 Gy; range 2.5–10) and concluded that this approach was effective with significant improvement of splenic pain and abdominal discomfort with a low rate of side effects [15].…”

Section: Discussionmentioning

confidence: 61%

Palliative splenic irradiation for symptomatic splenomegaly in non-Hodgkin lymphoma

Oliveira¹,

Fardilha²,

Louro³

et al. 2018

ecancer

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Introduction and aimsSplenic marginal zone lymphoma, an uncommon subtype of non-Hodgkin lymphoma (NHL), is usually present with symptomatic splenomegaly. Although splenectomy has long been considered the first-line therapy in symptomatic or cytopenic patients, it can lead to significant morbidity and mortality. Splenic irradiation is an option for patients who have a poor response to systemic therapy and/or are not surgical candidates. In this paper, we present a case report of a patient who received splenic radiotherapy for symptomatic splenomegaly.MethodsAn 85-year-old Caucasian man with a 4 year history of low-grade NHL presented with progressive pancytopenia, significant weight loss and symptomatic splenomegaly (abdominal discomfort, sense of fullness and limitation of mobility due to spleen size). The patient refused splenectomy and, in December 2017, was referred to palliative splenic radiotherapy. He was initially treated with five fractions of one Grey (Gy) in order to evaluate clinical and haematology response. After that, 1.5 Gy daily, 5 days a week for 3 weeks. 3D conformal radiotherapy, multiple fields and mixed energy (6 and 15 Mv) were used.ResultsRadiotherapy allowed significant splenic reduction to almost half the size, resolving abdominal discomfort and improving quality of life. There was no decline of haemoglobin, leukocytes and platelet counts; in fact, there was a marginal increase.ConclusionPalliative splenic irradiation was well tolerated confirming that it is a safe treatment option for palliation of symptomatic splenomegaly. Thereby, splenic irradiation should be strongly considered in the management of symptomatic splenomegaly, for selected patients who are refractory to or unsuitable for other options or when the patient refuses other treatments.

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“…In patients who are refractory to or unsuitable for surgery or chemotherapy, splenic irradiation is an option, and additionally has the potential to amplify response rates to immunochemotherapy with Rituximab if the patient requires further treatments [6]. Splenic irradiation has been shown in several small case series to be effective in the palliation of pain and abdominal discomfort in splenomegaly with success rates between 50 and 91% and minimal side effects [7][8][9].…”

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confidence: 99%

Successful Surgical Removal of the Largest Known Spleen

Hall

Dang

Shaw

2020

Case Reports in Surgery

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Background. Splenic marginal zone lymphoma (SMZL) is a rare subtype of non-Hodgkin lymphoma that typically presents with symptomatic splenomegaly. The optimal treatment of SMZL not well established. Case Presentation. A 44-year-old man with a history of low-grade B-cell lymphoproliferative disorder previously treated with chemotherapy presented with a three-month history of rapidly enlarging abdominal girth. He was found to have large symptomatic splenomegaly by computed tomography. After workup, he underwent preoperative angioembolization of the splenic artery followed by successful splenectomy. The spleen measured 45 cm in greatest dimension and weighed 12.14 kg, more than 12% of the patient’s total body weight, making this both the largest spleen on record as well as the largest spleen ever surgically removed. Pathology was consistent with splenic marginal zone lymphoma. The patient did well and was discharged home on postoperative day 3. Conclusions. SMZL is an infrequent condition that leads to progressive symptomatic splenomegaly which can be managed surgically providing symptomatic improvement and an overall satisfactory oncologic outcome. A multidisciplinary approach to complex cases of SMZL splenomegaly is imperative to achieving optimal outcomes.

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Radiotherapy of splenomegaly

Abstract: The present analysis documents the efficacy of RT. In addition, RT as a palliative treatment option for symptomatic SM should not be forgotten.

Cited by 21 publications

References 21 publications

Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data

Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data

Palliative splenic irradiation for symptomatic splenomegaly in non-Hodgkin lymphoma

Successful Surgical Removal of the Largest Known Spleen

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