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Clinical course of solitary extramedullary plasmacytoma.
Radiother Oncol. 1999 Sep; 52(3):245-9.RO

Abstract

BACKGROUND AND PURPOSE

Solitary extramedullary plasmacytoma (EMP) represents a rare category of malignant disease on which there are limited data in regard to diagnosis, staging and natural history. This study attempted to clarify the clinical course of solitary extramedullary plasmacytoma after radiation or surgical therapy given with curative intent.

MATERIALS AND METHODS

The diagnosis was based on a mass of clonal plasma cells separate from bone or bone marrow without evidence of occult disease elsewhere. Between 1963 and 1996, 22 previously untreated patients with an EMP were diagnosed. Disease presented in the head or neck in 86%, usually in the nasal cavity (NC) or maxillary sinus (MS), and in these areas local bone destruction was found in 10 of 11 patients. Among all patients, serum myeloma protein was present in three patients (14%) and Bence Jones protein alone was found in two patients (9%). Radiation therapy was the sole treatment for 18 of 22 patients, and the median radiotherapy dose was 50 Gy (range, 40-60 Gy); five of seven patients with an EMP of oral cavity (OC), oropharynx (OP), nasopharynx (NP), parotid or larynx also received elective neck irradiation. Two patients underwent surgery plus postoperative irradiation of a plasmacytoma of the sigmoid colon or pleura, and two patients had resection alone of a plasmacytoma of the colon or cervical lymph node.

RESULTS

Local control was achieved in 21 of 22 patients (95%), and disease never recurred in regional nodes. Disappearance of myeloma protein occurred in three of five patients with an evaluable abnormality. Multiple myeloma developed in seven patients (32%), all within 5 years. The 5-year rate of freedom from progression to multiple myeloma was 56% and the median survival was 9.5 years.

CONCLUSION

Radiation therapy achieved excellent locoregional control of EMP with an approximate cure fraction of 50%.

Authors+Show Affiliations

Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Centre, Houston 77030, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10580871

Citation

Liebross, R H., et al. "Clinical Course of Solitary Extramedullary Plasmacytoma." Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology, vol. 52, no. 3, 1999, pp. 245-9.
Liebross RH, Ha CS, Cox JD, et al. Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol. 1999;52(3):245-9.
Liebross, R. H., Ha, C. S., Cox, J. D., Weber, D., Delasalle, K., & Alexanian, R. (1999). Clinical course of solitary extramedullary plasmacytoma. Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology, 52(3), 245-9.
Liebross RH, et al. Clinical Course of Solitary Extramedullary Plasmacytoma. Radiother Oncol. 1999;52(3):245-9. PubMed PMID: 10580871.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical course of solitary extramedullary plasmacytoma. AU - Liebross,R H, AU - Ha,C S, AU - Cox,J D, AU - Weber,D, AU - Delasalle,K, AU - Alexanian,R, PY - 1999/12/2/pubmed PY - 1999/12/2/medline PY - 1999/12/2/entrez SP - 245 EP - 9 JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology JO - Radiother Oncol VL - 52 IS - 3 N2 - BACKGROUND AND PURPOSE: Solitary extramedullary plasmacytoma (EMP) represents a rare category of malignant disease on which there are limited data in regard to diagnosis, staging and natural history. This study attempted to clarify the clinical course of solitary extramedullary plasmacytoma after radiation or surgical therapy given with curative intent. MATERIALS AND METHODS: The diagnosis was based on a mass of clonal plasma cells separate from bone or bone marrow without evidence of occult disease elsewhere. Between 1963 and 1996, 22 previously untreated patients with an EMP were diagnosed. Disease presented in the head or neck in 86%, usually in the nasal cavity (NC) or maxillary sinus (MS), and in these areas local bone destruction was found in 10 of 11 patients. Among all patients, serum myeloma protein was present in three patients (14%) and Bence Jones protein alone was found in two patients (9%). Radiation therapy was the sole treatment for 18 of 22 patients, and the median radiotherapy dose was 50 Gy (range, 40-60 Gy); five of seven patients with an EMP of oral cavity (OC), oropharynx (OP), nasopharynx (NP), parotid or larynx also received elective neck irradiation. Two patients underwent surgery plus postoperative irradiation of a plasmacytoma of the sigmoid colon or pleura, and two patients had resection alone of a plasmacytoma of the colon or cervical lymph node. RESULTS: Local control was achieved in 21 of 22 patients (95%), and disease never recurred in regional nodes. Disappearance of myeloma protein occurred in three of five patients with an evaluable abnormality. Multiple myeloma developed in seven patients (32%), all within 5 years. The 5-year rate of freedom from progression to multiple myeloma was 56% and the median survival was 9.5 years. CONCLUSION: Radiation therapy achieved excellent locoregional control of EMP with an approximate cure fraction of 50%. SN - 0167-8140 UR - https://www.unboundmedicine.com/medline/citation/10580871/Clinical_course_of_solitary_extramedullary_plasmacytoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167814099001140 DB - PRIME DP - Unbound Medicine ER -