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Int J Radiat Oncol Biol Phys. 2006 Jan 1;64(1):210-7. Epub 2005 Oct 17.

Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients.

Author information

1
Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. mahmut.ozsahin@chuv.ch

Abstract

PURPOSE:

To assess the outcomes and patterns of failure in solitary plasmacytoma (SP).

METHODS AND MATERIALS:

The data from 258 patients with bone (n = 206) or extramedullary (n = 52) SP without evidence of multiple myeloma (MM) were collected. A histopathologic diagnosis was obtained for all patients. Most (n = 214) of the patients received radiotherapy (RT) alone; 34 received chemotherapy and RT, and 8 surgery alone. The median radiation dose was 40 Gy. The median follow-up was 56 months (range 7-245).

RESULTS:

The median time to MM development was 21 months (range 2-135), with a 5-year probability of 45%. The 5-year overall survival, disease-free survival, and local control rate was 74%, 50%, and 86%, respectively. On multivariate analyses, the favorable factors were younger age and tumor size <4 cm for survival; younger age, extramedullary localization, and RT for disease-free survival; and small tumor and RT for local control. Bone localization was the only predictor of MM development. No dose-response relationship was found for doses >30 Gy, even for larger tumors.

CONCLUSION:

Progression to MM remains the main problem. Patients with extramedullary SP had the best outcomes, especially when treated with moderate-dose RT. Chemotherapy and/or novel therapies should be investigated for bone or bulky extramedullary SP.

PMID:
16229966
DOI:
10.1016/j.ijrobp.2005.06.039
[Indexed for MEDLINE]

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