[Radiotherapy for myeloma]

The quality of life, as well as the length of survival, in patients with myeloma has improved since the introduction of melphalan chemotherapy. Although myeloma is a radio-responsive disease, radiotherapy should be chosen for relapsed and refractory myeloma, because prolongation of overall survival is not improved. The aim of radiotherapy for solitary plasmacytomas is to mainly relieve pain, rather than the curative local therapy. On the other hand, total body irradiation has been used, as palliative therapy, for relapsed and refractory myeloma but treatment related toxicity is commonly. The hemibody irradiation and whole bone marrow irradiation developed to decrease radiation pneumonitis and hematologic toxicity. On the other hand, the results of radiotherapy in combination with chemotherapy shows no better survival than that of chemotherapy alone. Radiotherapy should be used for severe intractable bone pain and should be employed, using a limited field in lytic lesions.