Rare Rib-Originating Solitary Plasmacytoma: Retrospective Analysis and Surgical Outcomes.

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Abstract

[Indexed for MEDLINE] 16. Am J Clin Oncol. 2009 Dec;32(6):612-7. doi: 10.1097/COC.0b013e31819cca18. Solitary plasmacytoma. Dagan R(1), Morris CG, Kirwan J, Mendenhall WM. Author information: (1)Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA. PURPOSE: To analyze the outcomes of patients treated for solitary plasmacytoma with definitive radiotherapy (RT). MATERIAL AND METHODS: Thirty-two patients with solitary plasmacytoma of bone (SPB; 22 patients) and extramedullary plasmacytoma (EMP; 10 patients) were treated between 1963 and 2006. The median RT dose was around 42.7 Gy (range, 15-54 Gy) over a median of 25 fractions (range, 1-32 fractions). No patient received adjuvant chemotherapy. Median follow-up was 10.1 years (range, 1-33 years). Median follow-up on living patients was 7.3 years (range, 2.1-33 years). RESULTS: The 10-year local-control rate after RT was 87%. All 4 patients who developed a local recurrence had SPBs > or = 5 cm. The 10-year multiple myeloma-free survival rates were: SPB, 30%; EMP, 90%; and overall, 50%. Progression to multiple myeloma occurred at a median of 25.1 months after RT. The 10-year overall and cause-specific survival rates were 65% and 77%, respectively. The 10-year cause-specific survival rate was 65% for patients with SPB versus 100% for those with EMP (P = 0.006). CONCLUSION: Moderate dose RT results in a high rate of local control. Patients with SPB are more likely to progress to multiple myeloma, which adversely affects their survival compared with those with EMP. DOI: 10.1097/COC.0b013e31819cca18