多发性骨髓瘤的放射治疗与全身疗法相结合-现代治疗时代的临界毒性评估
Michael Oertel1, Tom Schlusemann1, Evgenii Shumilov2
1Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Cancers
|June 10, 2023
概括
放射治疗 (RT) 与全身疗法 (ST) 结合治疗多发性骨髓瘤 (MM) 有效. 虽然通常是安全的,同时RT和ST增加高度的血液毒性,需要仔细监测后期治疗.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
背景情况:
- 放射治疗 (RT) 是多发性骨髓瘤 (MM) 的标准治疗方法,用于治疗骨损伤和疼痛.
- 将RT与全身疗法 (ST) 结合起来,对于控制这种多焦点疾病至关重要.
- 同时的RT和ST可能会增加与治疗相关的毒性.
研究的目的:
- 在多发性骨髓瘤 (MM) 患者中,先后评估系统疗法 (ST) 与放射疗法 (RT) 同时使用的耐受性和毒性.
- 评估RT前,期间和之后的非血液学和血液学毒性.
- 为了确定RT与ST的结合是否会影响毒性概况.
主要方法:
- 对82名多发性骨髓瘤患者的回顾性分析,这些患者接受了并发RT和ST治疗.
- 毒性记录在RT完成后的30天前至90天后.
- 统计分析,包括RT后高等级血液毒性的p值.
主要成果:
- 65.9%的患者经历了非血液学毒性 (17.1%高度).
- 在RT期间和之后,血液毒性增加了 (分别为73.2%和81.7%).
- 与RT并发的ST显著增加了RT后的高度血液毒性 (p = 0.018).
结论:
- 放射治疗可以安全地整合到现代多发性骨髓瘤治疗方案中.
- 即使在RT完成后,对毒性,特别是血液毒性进行密切监测是必不可少的.
- 同时的全身疗法需要仔细考虑,因为血液毒性风险增加.
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