The Pain Relief and Recalcification Results of Radiotherapy for Plasma Cell Tumors

Abstract

Multiple Myeloma (MM) and Solitary Plasmocytoma (SP) are given as Plasma Cell Neoplasms (PCNs). Radiotherapy (RT) is used for definitive and/or palliative purposes.We aimed to evaluate the role of RT upon pain relief,recalcification and local disease control for the patients with PCNs. From January 2009 to December 2016, total 80 patients were evaluated. Eleven (13.8%) patients were classified as SP, and 69 (86.3%) were as MM. The total treatment dose was 45 Gy with 1.8 Gy per fraction for the SP and total 30 Gy with 2.5-3 Gy per fraction for the MM. Numerical Rating Pain Scale (NRS) was used for pain level detection and the international consensus on palliative RT criteria was used for recalcification level classification before and after RT. Prior to RT, 56 (70%) patients suffered from severe pain, 19 (23.8%) patients suffered from moderate pain and only 5 (6.3%) patients reported mild pain. After RT, complete pain relief was achieved in 59 (73.8%) and partial pain relief was reported remaining 14 (17.5%) patients. We identified some kind of radiologic recalcification response in 77 (96.3%) patients. Complete and partial radiological response was recorded in 41 (51.3%) and 36 (45%) patients, respectively. Complete recalcification response was seen in 9 of 11 (82%) SP patients and 32 of 69 (46%) MM patients. The difference of complete recalcification response rates between two groups was significant (p= 0.031).Local disease control was achieved in 75 (94%) patients. The time interval after RT and applied RT doses are important factors for recalcification effect. Unlikely, pain relief can be achieved regardless of dose level. It can be stated that treatment doses over 30 Gy with multiple fractions should be suggested for the patients in good general condition with a life expectancy of > 1year.