Management of extramedullary plasmacytoma: Role of radiotherapy and prognostic factor analysis in 55 patients

Wen Ge ¹ Wang Weihu ¹ Zhang Yujing ² ^* Niu Shaoqing ³ Li Qiwen ² Li Yexiong ⁴ ^*

文摘	Objective: To investigate potential prognostic factors affecting patient outcomes and to evaluate the optimal methods and effects of radiotherapy(RT) in the management of extramedullary plasmacytoma(EMP). Methods: Data from 55 patients with EMP between November 1999 and August 2015 were collected. The median age was 51(range, 22-77) years. The median tumor size was 3.5(range, 1.0-15.0) cm. The median applied dose was 50.0(range, 30.0-70.0) Gy. Thirty-nine patients(70.9%) presented with disease in the head or neck region. Twelve patients received RT alone, 9 received surgery(S) alone, 3 received chemotherapy(CT) alone, and 3 patients did not receive any treatment. Combination therapies were applied in 28 patients. Results: The median follow-up duration was 56 months. The 5-year local recurrence-free survival(LRFS), multiple myeloma-free survival(MMFS), progression-free survival(PFS) and overall survival(OS) rates were 79.8%, 78.6%, 65.2% and 76.0%, respectively. Univariate analysis revealed that RT was a favourable factor for all examined endpoints. Furthermore, head and neck EMPs were associated with superior LRFS, MMFS and PFS. Tumor size <4 cm was associated with superior MMFS, PFS and OS; serum M protein negativity was associated with superior MMFS and PFS; age ≥50 years and local recurrence were associated with poor MMFS. The dose ≥45 Gy group exhibited superior 5-year LRFS, MMFS and PFS rates(94.7%, 94.4%, 90.0%, respectively), while the corresponding values for the dose <45 Gy group were 62.5%(P=0.008), 53.3%(P=0.036) and 41.7%(P<0.001). Conclusions: Involved-site RT of at least 45 Gy should be considered for EMP. Furthermore, patients with head and neck EMP, tumor size <4 cm, age <50 years and serum M protein negativity had better outcomes.
来源	Chinese Journal of Cancer Research ,2017,29(5):438-446 【核心库】
DOI	10.21147/j.issn.1000-9604.2017.05.08
关键词	Extramedullary plasmacytoma ; prognostic factors ; radiotherapy ; multiple myeloma
地址	1. Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, 100142 2. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China;;Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060 3. Department of Radiation Oncology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 4. Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100021
语种	英文
文献类型	研究性论文
ISSN	1000-9604
学科	肿瘤学
文献收藏号	CSCD:6101484