18例孤立性浆细胞瘤放射治疗疗效分析  

Clinical Results of Radiotherapy for 18 Patients with Solitary Plasmacytoma

作　　者：刘景杰[1] 张建军[1] 张长松 

机构地区：[1]江西省吉安市中心人民医院,江西吉安343000 [2]江苏省常州市肿瘤研究所

出　　处：《中国医学创新》2014年第35期124-126,共3页Medical Innovation of China

基　　金：江苏省临床医学专项基金(BL2013012)

摘　　要：目的：回顾分析2004年-2013年本院接受放射治疗的21例孤立性浆细胞瘤患者的疗效。方法：21例接受放射治疗的孤立性浆细胞瘤患者中,18例随访完整。10例患者骨孤立性浆细胞瘤（SBP）,8例患者为髓外浆细胞瘤（EP）。8例患者采用放射治疗为主的治疗,其他10例为部分切除术或脊柱减压后放疗。局部放疗中位剂量46 Gy（30~50.4 Gy）,分割剂量1.8~2.0 Gy。结果：随访期间共2例患者局部复发率,SBP和EP各1例。全组5年和10总生存率均为77.8%,SBP组与EP组间总生存率无显著差异（P〉0.05）。SBP和EP的5年无转化多发性骨髓瘤生存率有显著差异,分别为36.8%和86.7%（P=0.015）。结论：孤立性浆细胞瘤放射治疗的疗效好。而进展为多发性骨髓瘤,特别是骨孤立性浆细胞瘤,仍然是有待进一步研究。Objective：To evaluate retrospectively the clinical effect of local radiotherapy for 21 patients with solitary plasmacytoma between 2004 and 2013. Method： Among these 21 patients, 18 patients followed completely were analyzed.Ten patients suffered from solitary plasmacytoma of bone（SBP）, and eight patients from extra-medullary plasmacytoma（EP）. Eight cases were treated by radiation only, the other ten cases were treated by radiation post-operatively. Radiotherapy with a median dose of radiation was 46 Gy（30-50.4 Gy） with fraction of 1.8-2.0 Gy.Result：Excellent local control with only two patient suffering from local relapse was yielded. Both 5-years and 10-years over-all survival rate were similarily 77.8%. Between SBP and EP,no significant difference in overall survival rate could be detected（P〉0.05）. But 5-year multiple myeloma-free survival rates were significantly different with 36.8% and 86.7% respectively（P=0.015）. Conclusion：Radiotherapy can achieve excellent clinical effect for solitary plasmacytoma. Progression to multiple myeloma, especially in the case of SBP, remains to be addressed by further studies.

关 键 词：浆细胞瘤 多发性骨髓瘤 放射治疗 

分 类 号：R730.55[医药卫生—肿瘤] R733.3[医药卫生—临床医学]