Role of radiotherapy in solitary bone plasmacytomas

摘要: Background:  Solitary bone plasmacytoma (SBP) is a rare tumor for which the standard treatment remains local radiotherapy (RT). While this results in high rates of control, majority patients ultimately develop multiple myeloma (MM). Here we present 20-year multi-institutional review our experience an attempt to better understand natural history SBP and identify possible prognostic factors. Methods:  A total 44 were identified. The inclusion criteria presence solitary lesion with histologic confirmation plasma cells on biopsy, normal marrow aspiration trephine (<10% cells), negative radiographic skeletal survey, no anemia, hypercalcemia or renal impairment secondary cell dyscrasia. Patient ages ranged from 25 83 years (median 54 years) 64% had monoclonal paraprotein serum and/or urine. All received megavoltage RT doses ranging 30 54 Gy. Potential factors including age, gender, site involvement, absence soft tissue extension, at diagnosis, persistence disappearance following RT, time taken disappear use magnetic resonance imaging (MRI) staging evaluated determine their impact likelihood developing MM. Results:  Median follow up was 6 years (range 0.1–15.2 years). Effective control achieved 42 (95%) patients, but (68%) subsequently progressed MM median progression 1.6 years. survival initial diagnosis 7.5 years. We unable define any that associated increased risk MM. Conclusion:  Our series confirms excellent achievable RT. However, will progress strategies, such as adjuvant chemotherapy, should be explored selected patients.