Radiation Therapy
Targeted irradiation of solitary or limited (1-3) plasmacytomas
- Response rate
- 97% OS at 4 years
- Onset
- 3-36 months for full clinical improvement
- Route
- External beam RT, median 45 Gy (range 35-54 Gy)
- Line
- 1st
- IgM effect
- N/A (targets the plasma cell clone directly)
Evidence summary
For patients with 1-3 bone lesions and negative bone marrow, radiation is first-line and potentially curative. In the Mayo Clinic series (38 patients), 4-year OS was 97% and event-free survival was 52%. Symptoms improve over 3-36 months. More than half of treatment failures occurred within 12 months. Patients failing radiation can proceed to systemic therapy.