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The role of radiotherapy in the management of POEMS syndrome

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 analyze...

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Autores principales: Suh, Yang-Gun, Kim, Young-Suk, Suh, Chang-Ok, Kim, Yu Ri, Cheong, June-Won, Kim, Jin Seok, Cho, Jaeho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253631/
https://www.ncbi.nlm.nih.gov/pubmed/25431020
http://dx.doi.org/10.1186/s13014-014-0265-8
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author Suh, Yang-Gun
Kim, Young-Suk
Suh, Chang-Ok
Kim, Yu Ri
Cheong, June-Won
Kim, Jin Seok
Cho, Jaeho
author_facet Suh, Yang-Gun
Kim, Young-Suk
Suh, Chang-Ok
Kim, Yu Ri
Cheong, June-Won
Kim, Jin Seok
Cho, Jaeho
author_sort Suh, Yang-Gun
collection PubMed
description 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.
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spelling pubmed-42536312014-12-04 The role of radiotherapy in the management of POEMS syndrome Suh, Yang-Gun Kim, Young-Suk Suh, Chang-Ok Kim, Yu Ri Cheong, June-Won Kim, Jin Seok Cho, Jaeho Radiat Oncol Research 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. BioMed Central 2014-11-28 /pmc/articles/PMC4253631/ /pubmed/25431020 http://dx.doi.org/10.1186/s13014-014-0265-8 Text en © Suh et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Suh, Yang-Gun
Kim, Young-Suk
Suh, Chang-Ok
Kim, Yu Ri
Cheong, June-Won
Kim, Jin Seok
Cho, Jaeho
The role of radiotherapy in the management of POEMS syndrome
title The role of radiotherapy in the management of POEMS syndrome
title_full The role of radiotherapy in the management of POEMS syndrome
title_fullStr The role of radiotherapy in the management of POEMS syndrome
title_full_unstemmed The role of radiotherapy in the management of POEMS syndrome
title_short The role of radiotherapy in the management of POEMS syndrome
title_sort role of radiotherapy in the management of poems syndrome
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253631/
https://www.ncbi.nlm.nih.gov/pubmed/25431020
http://dx.doi.org/10.1186/s13014-014-0265-8
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