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Impact of Radiotherapy on Pain Relief and Recalcification in Plasma Cell Neoplasms

Long-Term Experience

Wirkung der Strahlentherapie auf Schmerzlinderung und Rekalzifizierung beim Multiplen Myelom und Plasmozytom: Langzeit-Erfahrung

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Purpose:

To evaluate the impact of radiotherapy on pain relief and on recalcification in patients with osteolytic lesions due to plasma cell neoplasm.

Patients and Methods:

Pain relief was evaluated according to a 0–10 verbal numerical rating scale (NRS) and recalcification was measured using radiological imaging.

Results:

From 1996–2007, 52 patients were treated (Table 1). Median total dose was 38 Gy (range, 16–50 Gy). Pain be-fore radiotherapy was reported by 45 of 52 (86.5%) patients (Table 2) as being severe (8 ≤ NRS ≤ 10) in 5 (11%), moderate (5 ≤ NRS ≤ 7) in 27 (60%), and mild in 13 (29%). Pain relief was achieved in 41 of 45 patients (91%): complete relief was ob-tained in 21 (51.2%) and partial relief in 20 patients (48.8%); patients with severe pain experienced resolution and none present-ed an increase of pain. Drugs reduction/suspension was achieved in 7 of the 21 patients with complete response. Of 42 patients evaluable for recalcification (Table 3), 21 (50%) presented a radiological response, which was identified as complete in 16 (38%).

Conclusion:

Our data confirm the effectiveness of radiotherapy for pain relief, including a reduction in drug intake, and on recalcification, thus, supporting its use in a multidisciplinary approach.

Ziel:

Beurteilung der Wirkung der Strahlentherapie auf Schmerzlinderung und Rekalzifizierung bei Patienten mit Osteolysen auf Grund von malignen Plasmazellerkrankungen.

Patienten und Methodik:

Die Schmerzlinderung wurde anhand einer 0–10 numerischen Verbalskala (NVS) beurteilt, während die Rekalzifizierungsrate mittels radiologischer bildgebender Verfahren gemessen wurde.

Ergebnisse:

Von 1996 bis 2007 wurden 52 Patienten behandelt (Tabelle 1). Die mittlere Bestrahlungsdosis betrug 38 Gy (range 16–50 Gy). Schmerzen wurden vor der Strahlentherapie von 45 der 52 (86,5%) Patienten beurteilt (Tablle 2): als schwer (8 ≤ NVS ≤ 10) von 5 (11%), als mittelgradig (5 ≤ NRS ≤ 7) von 27 (60%) und als leicht von 13/45 (29%). Eine Schmerzlinderung wurde bei 41 der 45 (91%) Patienten erreicht: eine vollständige Schmerzkontrolle bei 21 (51,2%) und eine teilweise Linderung bei 20 Patienten (48,8%); alle Patienten mit ausgeprägter Schmerzsymptomatik erfuhren eine Reduktion der Schmerzen, und bei keinem Patienten nahmen die Schmerzen zu. Die Schmerzmedikation konnte bei 7/21 Patienten mit vollständiger Schmerzkontrolle verringert oder abgesetzt werden. Eine Rekalzifizierung wurde bei 42 Patienten radiologisch beurteilt (Tabelle 3): 21 (50%) zeigten eine Verbesserung, eine komplette Rekalzifizierung wurde bei 16 (38%) Patienten beobachtet.

Schlussfolgerung:

Unsere Daten bestätigen die Wirksamkeit der Strahlentherapie, die in einer multidisziplinären Strategie bei malignen Plasmazellerkrankungen eingesetzt werden kann, um eine Schmerzlinderung mit Reduzierung der Schmerzmittelmedikation und eine Rekalzifizierung zu erreichen.

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Authors and Affiliations

  1. Radiotherapy Department, University Hospital “Gemelli”, Rome, Italy

    Mario Balducci, Silvia Chiesa MD, Stefania Manfrida, Vincenzo Frascino, Giovanna Mantini, Giuseppe Roberto D’Agostino, Maria Antonietta Gambacorta & Vincenzo Valentini

  2. Hematology Department, University Hospital “Gemelli”, Rome, Italy

    Elena Rossi, Tommaso Za, Stefan Hohaus & Valerio De Stefano

  3. Radiotherapy Oncology Department, University Hospital Lyon Sud, Pierre Benite, Lyon Sud, France

    Berardino De Bari

  4. Radiotherapy Department, University Hospital “Campus Biomedico”, Rome, Italy

    Francesco Cellini

  5. Radiology Department, University Hospital “Gemelli”, Rome, Italy

    Antonello Leone

  6. Radiotherapy Department, University Hospital “Gemelli”, L.go Agostino Gemelli 8, 0168, Rome, Italy

    Silvia Chiesa MD

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  1. Mario Balducci
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Correspondence to Silvia Chiesa MD.

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Balducci, M., Chiesa, S., Manfrida, S. et al. Impact of Radiotherapy on Pain Relief and Recalcification in Plasma Cell Neoplasms. Strahlenther Onkol 187, 114–119 (2011). https://doi.org/10.1007/s00066-010-2155-9

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  • DOI: https://doi.org/10.1007/s00066-010-2155-9

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