Abstract
Objectives
Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells. Definitive RT can result in long-term local control of the SP. Due to the small number of patients and narrow range of doses, phase III randomized trials are lacking. The aim of this study is to further support the potential use of RT for the treatment of SP.
Methods
Clinical data of all patients treated for SP at our Institution between 1992 and 2018 were reviewed. A total of 42 consecutive patients were analyzed.
Results
The median follow-up was 84.8 months. Radiation dose did not differ significantly as a function of sex, type of SP (solitary bone plasmacytoma or as extramedullary plasmacytoma), tumor size; conversely differs significantly as a function of age (p = 0.04). The 5y-OS and 10y-OS were, respectively, 96 and 91%. Local recurrences developed in 21.4% of patients (9/42). 16 patients progressed to MM (38.1%). The 5y-progression to MM free survival (PMFS) and the 10y-PMFS were, respectively, 68.6 and 61.9%.
Conclusions
Our data confirm that good results are achievable with RT to treat SP, but they don’t allow defining a dose–effect correlation; therefore, it remains uncertain which is the most effective dose and whether lower doses can guarantee adequate disease control.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Caers J, Paiva B, Zamagni E et al (2018) Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European Expert Panel. J Hematol Oncol 11(1):10. https://doi.org/10.1186/s13045-017-0549-1
De Waal EG, Leene M, Veeger N et al (2016) Progression of a solitary plasmacytoma to multiple myeloma. A population-based registry of the northern Netherlands. Br J Haematol 175:661–667. https://doi.org/10.1111/bjh.14291
Dimopoulos MA, Moulopoulos LA, Maniatis A, Alexanian R (2000) Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood 96:2037–2044
Grammatico S, Scalzulli E, Petrucci MT (2017) Solitary plasmacytoma. Mediterr J Hematol Infect Dis 9(1):e2017052
Humeniuk MS, Gertz MA, Lacy MQ et al (2013) Outcomes of patients with POEMS syndrome treated initially with radiation. Blood 122:68–73. https://doi.org/10.1182/blood-2013-03-487025
Katodritou E, Terpos E, Symeonidis AS et al (2014) Clinical features, outcome, and prognostic factors for survival and evolution to multiple myeloma of solitary plasmacytomas: a report of the Greek myeloma study group in 97 patients. Am J Hematol 89:803–808. https://doi.org/10.1002/ajh.23745
Kilciksiz S, Celik OK, Pak Y, et al. Turkish Oncology Group-Sarcoma Working Party (2008) Clinical and prognostic features of plasmacytomas: a multicenter study of Turkish Oncology Group-Sarcoma Working Party. Am J Hematol 83:702–7. 10.1002/ajh.21211
Knobel D, Zouhair A, Tsang RW et al (2006) Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study. BMC cancer 6:118. https://doi.org/10.1186/1471-2407-6-118
Kumar SK, Callander NS, Alsina M et al (2017) Multiple myeloma, version 32017, NCCN clinical practice guidelines in oncology. J Natl Compre Cancer Netw JNCCN 15(2):230–269. https://doi.org/10.6004/jnccn.2017.0023
Liebross RH, Ha CS, Cox JD et al (1998) Solitary bone plasmacytoma: outcome and prognostic factors following radiotherapy. Int J Radiat Oncol Biol Phys 41:1063–1067. https://doi.org/10.1016/s0360-3016(98)00186-2
Mayr NA, Wen BC, Hussey DH et al (1990) The role of radiation therapy in the treatment of solitary plasmacytomas. Radiother Oncol 17:293–303. https://doi.org/10.1016/0167-8140(90)90003-f
Mendenhall CM, Thar TL, Million RR (1980) Solitary plasmacytoma of bone and soft tissue. Int J Radiat Oncol Biol Phys 6:1497–1501. https://doi.org/10.1016/0360-3016(80)90006-1
Moulopoulos LA, Dimopoulos MA, Weber D et al (1993) Magnetic resonance imaging in the staging of solitary plasmacytoma of bone. J Clin Oncol 11:1311–1315. https://doi.org/10.1200/JCO.1993.11.7.1311
Ozsahin M, Tsang RW, Poortmans P et al (2006) Outcomes and patterns of failure in solitary plasmacytoma: a multicenter rare cancer network study of 258 patients. Int J Radiat Oncol Biol Phys 64:210–217. https://doi.org/10.1016/j.ijrobp.2005.06.039
Rajkumar SV, Dimopoulos MA, Palumbo A et al (2014) International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 15:e538–e548. https://doi.org/10.1016/S1470-2045(14)70442-5
Reed V, Shah J, Medeiros LJ et al (2011) Solitary plasmacytomas: Outcome and prognostic factors after definitive radiation therapy. Cancer 117:4468–4474. https://doi.org/10.1002/cncr.26031
Sasaki R, Yasuda K, Abe E et al (2012) Multi-institutional analysis of solitary extramedullary plasmacytoma of the head and neck treated with curative radiotherapy. Int J Radiat Oncol Biol Phys 82:626–634. https://doi.org/10.1016/j.ijrobp.2010.11.037
Soutar R, Lucraft H, Jackson G et al (2004) Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Br J Haematol 124:717–726. https://doi.org/10.1111/j.1365-2141.2004.04834.x
Strojan P, Soba E, Lamovec J, Munda A (2002) Extramedullary plasmacytoma: clinical and histopathologic study. Int J Radiat Oncol Biol Phys 53:692–701. https://doi.org/10.1016/s0360-3016(02)02780-3
Thumallapally N, Meshref A, Mousa M, Terjanian T (2017) Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA. BMC Cancer 17:13. https://doi.org/10.1186/s12885-016-3015-5
Tournier-Rangeard L, Lapeyre M, Graff-Caillaud P et al (2006) Radiotherapy for solitary extramedullary plasmacytoma in the head-and neck region: a dose greater than 45 Gy to the target volume improves the local control. Int J Radiat Oncol Biol Phys 64:1013–1017. https://doi.org/10.1016/j.ijrobp.2005.09.019
Tsang RW, Gospodarowicz MK, Pintilie M et al (2001) Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int J Radiat Oncol Biol Phys 50:113–120. https://doi.org/10.1016/s0360-3016(00)01572-8
Tsang RW, Campbell BA, Goda JS et al (2018) Radiation therapy for solitary plasmacytoma and multiple myeloma: guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys 101(4):794–808. https://doi.org/10.1016/j.ijrobp.2018.05.009
Wilder RB, Ha CS, Cox JD et al (2002) Persistence of myeloma protein for more than one year after radiotherapy is an adverse prognostic factor in solitary plasmacytoma of bone. Cancer 94:1532–1537. https://doi.org/10.1002/cncr.10366
Zhu Q, Zou X, You R et al (2016) Establishment of an innovative staging system for extramedullary plasmacytoma. BMC Cancer 16:777. https://doi.org/10.1186/s12885-016-2824-x
Funding
No funding was received.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
There were no conflicts of interests.
Ethics approval
This retrospective study was approved by the Ethics Committee of Brescia—Italy with registration number 3778.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Alghisi, A., Borghetti, P., Maddalo, M. et al. Radiotherapy for the treatment of solitary plasmacytoma: 7-year outcomes by a mono-institutional experience. J Cancer Res Clin Oncol 147, 1773–1779 (2021). https://doi.org/10.1007/s00432-020-03452-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-020-03452-y