Palliative radiotherapy in patients with multiple myeloma

Area of Science:

• Oncology
• Radiotherapy
• Hematology

Background:

• Multiple myeloma (MM) is a cancer of plasma cells.
• Bone lesions and extramedullary soft tissue formations are common complications of MM.
• Palliative radiation therapy (RT) is a treatment modality used to manage symptoms in cancer patients.

Purpose of the Study:

• To evaluate the therapeutic effect of palliative RT in multiple myeloma (MM) patients with bone lesions and soft tissue formations.
• To compare the efficacy of two different RT regimens.
• To assess the impact of RT on MM disease parameters and patient survival.

Main Methods:

• A 10-year study (1994-2004) of 162 MM patients.
• Eighty-seven patients with myeloma bone disease (MBD) received palliative RT with two different regimens.
• Comparison of 10 parameters before and after RT, and survival analysis using Kaplan-Meier and log-rank tests.

Main Results:

• RT was administered to 92.1% of patients with vertebral fractures, 90.9% with non-vertebral fractures, and 94.1% with extramedullary tumors.
• Complete or partial pain palliation was achieved in 89.6% of patients; neurologic symptoms resolved in 58.6%.
• No significant changes were observed in hemoglobin, WBC, platelet counts, bone marrow infiltration, or serum markers (Ca, creatinine, albumin, CRP, LDH, beta2-microglobulin) post-RT. Median survival was similar for irradiated (32 months) and non-irradiated (33 months) groups, and between RT regimens (32 vs. 34 months).

Conclusions:

• Palliative RT is highly effective for pain palliation in multiple myeloma bone fractures and reducing extramedullary disease.
• Radiation therapy does not significantly influence the survival of patients with multiple myeloma.
• Different RT regimens showed comparable survival outcomes.