Solitary bone plasmacytoma: Outcome and prognostic factors following radiotherapy

Robert H. Liebross, Chul S. Ha, James D. Cox, Donna Weber, Kay Delasalle, Raymond Alexanian

Research output: Contribution to journalArticle

131 Scopus citations

Abstract

Purpose: To clarify the natural history of solitary plasmacytoma of bone (SBP) after radiation treatment. Methods and Materials: Between 1965-1996, we identified 57 previously untreated patients with a SBP. A serum myeloma protein was present in 33 patients (58%) and Bence Jones proteinuria was present in an additional eight patients (14%). The median radiotherapy dose was 50 Gy (range, 30-70 Gy). Overall survival, cause-specific survival, and freedom from progression to multiple myeloma were calculated actuarially. Results: Local control was achieved in 55 of 57 patients (96%). For those 29 patients (51%) who subsequently developed multiple myeloma, the median time to progression was 1.8 years. There was a direct correlation between persistence of abnormal protein following radiotherapy and the likelihood of developing multiple myeloma. Among 11 patients with disappearance of myeloma protein, only two developed multiple myeloma after 4 and 12 years, in contrast to progression in 57% of patients with a persistent protein peak and 63 % of those with nonsecretory disease (p = 0.02). Among 23 patients with thoracolumbar spine disease, 7 of 8 patients staged with plain radiographs alone developed multiple myeloma in comparison with 1 of 7 patients who also had magnetic resonance imaging (MRI) (p = 0.08). For all patients, the median survival from radiotherapy was 11.0 years. The median cause-specific survival of patients with disappearance of myeloma protein was significantly longer than that of the remaining patients (p = 0.004). Conclusion: Results supported the importance of precise staging that includes MRI of the spine for optimum patient selection and the application of definitive radiotherapy. Those patients with myeloma protein that disappears following radiotherapy represent a category with a high likelihood of cure.

Original languageEnglish (US)
Pages (from-to)1063-1067
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume41
Issue number5
DOIs
StatePublished - Jul 15 1998

Keywords

  • Multiple myeloma
  • Radiotherapy
  • Solitary bone plasmacytoma

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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