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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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