Multi-Institutional Analysis of Solitary Extramedullary Plasmacytoma of the Head and Neck Treated With Curative Radiotherapy

Journal Article · Wed Feb 01 04:00:00 EST 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2010.11.037· OSTI ID:22056004

Sasaki, Ryohei ^[1]; Yasuda, Koichi ^[2]; Abe, Eisuke ^[3]; Uchida, Nobue ^[4]; Kawashima, Mitsuhiko ^[5]; Uno, Takashi ^[6]; Fujiwara, Masayuki ^[7]; Shioyama, Yoshiyuki ^[8]; Kagami, Yoshikazu ^[9]; Shibamoto, Yuta ^[10]; Nakata, Kensei ^[11]; Takada, Yoshie ^[12]; Kawabe, Tetsuya; Uehara, Kazuyuki ^[1]; Nibu, Kenichi ^[13]; Yamada, Syogo ^[14]

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1. Division of Radiation Oncology, Kobe University Graduate School of Medicine (Japan)
2. Department of Radiology, Hokkaido University School of Medicine (Japan)
3. Division of Radiation Oncology, Graduate School of Medical and Dental Sciences, Niigata University (Japan)
4. Department of Radiation Oncology, Shimane University Faculty of Medicine (Japan)
5. Radiation Oncology Division, National Cancer Center Hospital East (Japan)
6. Department of Radiology, Graduate School of Medicine, Chiba University (Japan)
7. Department of Radiology, Hyogo College of Medicine (Japan)
8. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University (Japan)
9. Radiation Oncology Division, National Cancer Center Hospital (Japan)
10. Department of Radiology, Nagoya City University Graduate School of Medical Sciences (Japan)
11. Department of Radiology, Sapporo Medical University (Japan)
12. Department of Radiology, Osaka City University Graduate School of Medicine (Japan)
13. Division of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine (Japan)
14. Department of Radiation Oncology, Tohoku University School of Medicine (Japan)

Purpose: The purpose of this study was to elucidate the efficacy and optimal method of radiotherapy in the management of solitary extramedullary plasmacytoma occurring in the head and neck regions (EMPHN). Methods and Materials: Sixty-seven patients (43 male and 24 female) diagnosed with EMPHN between 1983 and 2008 at 23 Japanese institutions were reviewed. The median patient age was 64 years (range, 12-83). The median dose administered was 50 Gy (range, 30-64 Gy). Survival data were calculated by the Kaplan-Meier method. Results: The median follow-up duration was 63 months. Major tumor sites were nasal or paranasal cavities in 36 (54%) patients, oropharynx or nasopharynx in 16 (23%) patients, orbita in 6 (9%) patients, and larynx in 3 (5%) patients. The 5- and 10-year local control rates were 95% and 87%, whereas the 5- and 10-year disease-free survival rates were 56% and 54%, respectively. There were 5 (7.5%), 12 (18%), and 8 (12%) patients who experienced local failure, distant metastasis, and progression to multiple myeloma, respectively. In total, 18 patients died, including 10 (15%) patients who died due to complications from EMPHN. The 5- and 10-year overall survival (OS) rates were 73% and 56%, respectively. Radiotherapy combined with surgery was identified as the lone significant prognostic factor for OS (p = 0.04), whereas age, gender, radiation dose, tumor size, and chemotherapy were not predictive. No patient experienced any severe acute morbidity. Conclusions: Radiotherapy was quite effective and safe for patients with EMPHN. Radiotherapy combined with surgery produced a better outcome according to survival rates. These findings require confirmation by further studies with larger numbers of patients with EMPHN.

• OSTI ID: 22056004
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 82; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
DISEASE INCIDENCE
FAILURES
FEMALES
GY RANGE 10-100
LARYNX
MALES
METASTASES
NECK
NEOPLASMS
NOSE
PATIENTS
PHARYNX
RADIATION DOSES
RADIOTHERAPY
SURGERY