Alessandro Alghisi1, Paolo Borghetti2, Marta Maddalo2, Aldo Maria Roccaro3, Alessandra Tucci4, Rosario Mazzola5, Stefano Maria Magrini2, Antonio Lo Casto6, Marco Lorenzo Bonù2, Davide Tomasini2, Nadia Pasinetti2, Gloria Peretto2, Francesco Bertagna7, Cesare Tomasi8, Michela Buglione2, Luca Triggiani2. 1. Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy. ale.alghisi@libero.it. 2. Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy. 3. Clinical Research Development and Phase I Unit, ASST Spedali Civili Di Brescia, Brescia, Italy. 4. Division of Haematology, ASST Spedali Civili, Brescia, Italy. 5. Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy. 6. Radiation Oncology School, University of Palermo, Palermo, Italy. 7. Nuclear Medicine Department, Brescia University, Brescia, Italy. 8. Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy.
Abstract
OBJECTIVES: Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells. Definitive RT can result in long-term local control of the SP. Due to the small number of patients and narrow range of doses, phase III randomized trials are lacking. The aim of this study is to further support the potential use of RT for the treatment of SP. METHODS: Clinical data of all patients treated for SP at our Institution between 1992 and 2018 were reviewed. A total of 42 consecutive patients were analyzed. RESULTS: The median follow-up was 84.8 months. Radiation dose did not differ significantly as a function of sex, type of SP (solitary bone plasmacytoma or as extramedullary plasmacytoma), tumor size; conversely differs significantly as a function of age (p = 0.04). The 5y-OS and 10y-OS were, respectively, 96 and 91%. Local recurrences developed in 21.4% of patients (9/42). 16 patients progressed to MM (38.1%). The 5y-progression to MM free survival (PMFS) and the 10y-PMFS were, respectively, 68.6 and 61.9%. CONCLUSIONS: Our data confirm that good results are achievable with RT to treat SP, but they don't allow defining a dose-effect correlation; therefore, it remains uncertain which is the most effective dose and whether lower doses can guarantee adequate disease control.
OBJECTIVES: Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells. Definitive RT can result in long-term local control of the SP. Due to the small number of patients and narrow range of doses, phase III randomized trials are lacking. The aim of this study is to further support the potential use of RT for the treatment of SP. METHODS: Clinical data of all patients treated for SP at our Institution between 1992 and 2018 were reviewed. A total of 42 consecutive patients were analyzed. RESULTS: The median follow-up was 84.8 months. Radiation dose did not differ significantly as a function of sex, type of SP (solitary bone plasmacytoma or as extramedullary plasmacytoma), tumor size; conversely differs significantly as a function of age (p = 0.04). The 5y-OS and 10y-OS were, respectively, 96 and 91%. Local recurrences developed in 21.4% of patients (9/42). 16 patients progressed to MM (38.1%). The 5y-progression to MM free survival (PMFS) and the 10y-PMFS were, respectively, 68.6 and 61.9%. CONCLUSIONS: Our data confirm that good results are achievable with RT to treat SP, but they don't allow defining a dose-effect correlation; therefore, it remains uncertain which is the most effective dose and whether lower doses can guarantee adequate disease control.
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