Radiotherapy for the treatment of solitary plasmacytoma: 7-year outcomes by a mono-institutional experience
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Radiotherapy for the treatment of solitary plasmacytoma: 7‑year outcomes by a mono‑institutional experience Alessandro Alghisi1 · Paolo Borghetti1 · Marta Maddalo1 · Aldo Maria Roccaro2 · Alessandra Tucci3 · Rosario Mazzola4 · Stefano Maria Magrini1 · Antonio Lo Casto5 · Marco Lorenzo Bonù1 · Davide Tomasini1 · Nadia Pasinetti1 · Gloria Peretto1 · Francesco Bertagna6 · Cesare Tomasi7 · Michela Buglione1 · Luca Triggiani1 Received: 18 May 2020 / Accepted: 4 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Plasma cell neoplasms · Radical radiotherapy · Multiple myeloma · Solitary plasmacytoma
Introduction * Alessandro Alghisi [email protected] 1
Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100 Brescia, Italy
2
Clinical Research Development and Phase I Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
3
Division of Haematology, ASST Spedali Civili, Brescia, Italy
4
Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar‑Verona, Italy
5
Radiation Oncology School, University of Palermo, Palermo, Italy
6
Nuclear Medicine Department, Brescia University, Brescia, Italy
7
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy
Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells, presenting with either minimal or absent bone marrow (BM) plasmacytosis and without any evidence of systemic involvement, as demonstrated by the lack of BM clonal plasma cell infiltration and absence of end-organ damage (Rajkumar et al. 2014). SP is a ra
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