Zusammenfassung
Das solitäre Plasmozytom und das multiple Myelom fordern eine differenzierte Strahlenbehandlung. Bei Plasmozytomen führt eine Bestrahlung mit ausreichender Gesamtdosis (medullär 40–50 Gy oder extramedullär 50–60 Gy) zu einer hohen Lokalkontrolle mit einer geringen Rate an Nebenwirkungen. Beim multiplen Myelom kann die Strahlentherapie eine effektive Palliation sowohl hinsichtlich Rekalzifikation als auch Reduktion neurologischer Symptomatik und Analgesie erzielen. Hinsichtlich der Analgesie gilt: Je höher die Einzeldosis, desto schneller der Wirkeintritt. Im Rahmen einer Konditionierungstherapie vor Stammzelltransplantation trägt die Strahlentherapie zur Etablierung eines Graft-versus-Myelom-Effekts (GvM) bei.
Abstract
Solitary plasmacytoma and multiple myeloma require a differentiated radiotherapy. The irradiation for plasmacytoma with an adequate total dose (medullary 40–50 Gy or extramedullary 50–60 Gy) leads to a high degree of local control with a low rate of side effects. In cases of multiple myeloma radiotherapy will achieve effective palliation, both in terms of recalcification as well as reduction of neurological symptoms and analgesia. In terms of analgesia the rule is the higher the single dose fraction the faster the reduction of pain. As part of a conditioning treatment prior to stem cell transplantation radiotherapy contributes to the establishment of a graft versus myeloma effect (GVM).
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Interessenkonflikt. M.C. Schmaus und D. Neuhof geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Schmaus, M., Neuhof, D. Strahlentherapie bei solitärem Plasmozytom und multiplem Myelom. Radiologe 54, 551–555 (2014). https://doi.org/10.1007/s00117-013-2630-2
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DOI: https://doi.org/10.1007/s00117-013-2630-2