The Role of Radiation Therapy in the Management of POEMS Syndrome
| Autor: | Jung Jun Lee, J. Cho, Yang Gun Suh, Chang Kook Suh, Yun Kwon Kim, Jihye Cha |
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| Rok vydání: | 2012 |
| Předmět: |
Cancer Research
medicine.medical_specialty Univariate analysis Chemotherapy Radiation business.industry medicine.medical_treatment Plasma cell medicine.disease Gastroenterology Hematologic Response Radiation therapy medicine.anatomical_structure Oncology Refractory Internal medicine Medicine Radiology Nuclear Medicine and imaging business Polyneuropathy POEMS syndrome |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 84:S622 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2012.07.1662 |
| Popis: | Background: POEMS syndrome is a paraneoplastic syndrome caused by an underlying plasma cell proliferative disease. In this study, we examined the treatment outcomes and role of radiotherapy in the management of POEMS syndrome. Methods: In total, 33 patients diagnosed with POEMS syndrome were analyzed. These patients presented with osteosclerotic myeloma (OSM, n = 13), Castleman’s disease (CD, n = 4), OSM with CD (n = 10), and vascular endothelial growth factor elevation without gross lesions (VEGFe, n = 6), respectively. The patients were treated by radiotherapy alone (n = 4), chemotherapy alone (n = 16), or a combination thereof (n = 9). Results: The clinical response rates of radiotherapy, chemotherapy, and radiotherapy plus chemotherapy were 75%, 69%, and 89%, respectively. In addition, the hematologic response rates were 50%, 69%, and 71%, respectively. Among the six patients with limited multiple lesions who underwent radiotherapy, the clinical symptoms were improved in five patients after radiotherapy. The median progression-free survival (PFS) was 51 months, and the median overall survival (OS) was 65 months. In univariate analysis, the administration of chemotherapy was significantly associated with better PFS (p = 0.007) and OS (p = 0.020). In contrast, underlying VEGFe was a significant factor worsening PFS (p = 0.035) and OS (p = 0.008). Conclusions: Radiotherapy produces a reliable clinical response and is effective in improving POEMS-associated symptoms that are refractory to chemotherapy in selected patients with clustered or limited multiple lesions that can be covered by single radiation field. |
| Databáze: | OpenAIRE |
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