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

Journal Article · Sun Jan 01 04:00:00 EST 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20788287

Ozsahin, Mahmut ^[1]; Tsang, Richard W ^[2]; Poortmans, Philip ^[3]; Belkacemi, Yazid ^[4]; Bolla, Michel ^[5]; Oner Dincbas, Fazilet ^[6]; Landmann, Christine ^[7]; Castelain, Bernard ^[8]; Buijsen, Jeroen ^[9]; Curschmann, Juergen ^[10]; Kadish, Sidney P ^[11]; Kowalczyk, Anna ^[12]; Anacak, Yavuz ^[13]; Hammer, Josef ^[14]; Nguyen, Tan D ^[15]; Studer, Gabriela ^[16]; Cooper, Rachel ^[17]; Sengoez, Meric ^[18]; Scandolaro, Luciano ^[19]; Zouhair, Abderrahim ^[1]

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1. Dept. of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)
2. Dept. of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada)
3. Dept. of Radiation Oncology, Dr. Bernard Verbeeten Institute, Tilburg (Netherlands)
4. Dept. of Radiation Oncology, Hopital Tenon, Paris (France)
5. Dept. of Radiation Oncology, Centre Hospitalier Universitaire, Grenoble (France)
6. Dept. of Radiation Oncology, Istanbul University Cerrahpasa School of Medicine, Istanbul (Turkey)
7. Dept. of Radiation Oncology, Kantonsspital, Basel (Switzerland)
8. Dept. of Radiation Oncology, Centre Oscar-Lambret, Lille (France)
9. Dept. of Radiation Oncology, MAASTRO, Maastricht (Netherlands)
10. Dept. of Radiation Oncology, Inselspital, Bern (Switzerland)
11. Dept. of Radiation Oncology, Lahey Clinic, Burlington, MA (United States)
12. Dept. of Radiation Oncology, Medical University, Gdansk (Poland)
13. Dept. of Radiation Oncology, Ege University Medical School, Izmir (Turkey)
14. Dept. of Radiation Oncology, Barmherzige Schwestern Hospital, Linz (Austria)
15. Dept. of Radiation Oncology, Institut Jean-Godinot, Reims (France)
16. University Hospital, Zurich (Switzerland)
17. Dept. of Radiation Oncology, Dokuz Eyluel University Medical School, Izmir (Turkey)
18. Dept. of Radiation Oncology, Marmara University Hospital, Istanbul (Turkey)
19. Dept. of Radiation Oncology, Ospedale Sant' Anna, Como (Italy)

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.

• OSTI ID: 20788287
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 64; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
DIAGNOSIS
DOSE-RESPONSE RELATIONSHIPS
FAILURES
MULTIVARIATE ANALYSIS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SKELETON
SURGERY