Benefit of radiotherapy in patients with plasmacytoma and multiple myeloma

Treatment options for patients with plasmacytoma or multiple myeloma should be discussed in an interdisciplinary context. This systematic review focusses on the importance of radiotherapy in multiple myeloma and plasmacytoma. Summary of local radio-oncological treatment options for patients with plasmacytoma and multiple myeloma. A systematic literature search and analysis was performed to summarize the current evidence on the topic. Patients with plasmacytoma should be primarily treated with curatively dosed radiotherapy with or without surgery. Irradiation concepts may vary depending on risk factors and manifestation (solitary bone plasmacytoma vs. solitary extramedullary plasmacytoma). Although local control rates are high after radiotherapy, progression to multiple myeloma frequently occurs. In patients with multiple myeloma radiation is mainly used in palliative settings for pain relief, prevention of fractures or in patients who suffer from neurological symptoms due to spinal cord compression. Irradiation dose and fractionation should be selected based on treatment indications and the general condition of the patient. Although most patients receive systemic treatment at initial diagnosis, approximately 40% of patients with multiple myeloma will require radiation during the course of disease. While radiation is mainly used for palliative reasons in patients with multiple myeloma, it represents the primary and curative treatment option in patients with plasmacytoma.