Systemic irradiation in multiple myeloma: a report on nineteen cases

Area of Science:

• Oncology
• Radiation Oncology

Background:

• Multiple myeloma is a hematologic malignancy characterized by uncontrolled plasma cell proliferation.
• Relapsed or resistant multiple myeloma presents significant treatment challenges, necessitating novel therapeutic approaches.

Purpose of the Study:

• To evaluate the safety and efficacy of sequential half-body irradiation (HBI) in patients with relapsed or resistant multiple myeloma.
• To assess patient tolerance, toxicity, and survival outcomes associated with HBI treatment.

Main Methods:

• Nineteen patients with relapsed/resistant multiple myeloma received sequential HBI (12 patients) or HBI only (7 patients).
• Treatment involved sequential irradiation of either the upper or lower body, followed by the remaining half if tolerated.
• Patient-reported outcomes, toxicity, and survival were monitored.

Main Results:

• The treatment was generally well-tolerated, with transient gastrointestinal toxicity and acceptable hematological toxicity.
• Subjective improvement was reported in 17 patients, with pain relief within 24 hours.
• Objective responses were observed in 6 patients, and the median survival was 6 months, with 5 patients alive at 11-28 months.

Conclusions:

• Sequential HBI is an acceptable and potentially more economical treatment option for relapsed/resistant multiple myeloma compared to second-line chemotherapy.
• While toxicity was manageable, careful monitoring for complications like radiation pneumonitis and secondary infections is warranted.
• Further investigation in larger patient cohorts is recommended to confirm these findings.