Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-12-03 DOI:10.1016/j.adro.2024.101696

Andrea Emanuele Guerini MD , Eneida Mataj MD , Paolo Borghetti MD , Luca Triggiani , Ludovica Pegurri MD , Stefania Nici , Stefano Riga , Alessandra Tucci MD , Angelo Belotti MD , Marco Lorenzo Bonù MD , Giorgio Facheris MD , Stefano Maria Magrini , Luigi Spiazzi , Michela Buglione

{"title":"Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma","authors":"Andrea Emanuele Guerini MD , Eneida Mataj MD , Paolo Borghetti MD , Luca Triggiani , Ludovica Pegurri MD , Stefania Nici , Stefano Riga , Alessandra Tucci MD , Angelo Belotti MD , Marco Lorenzo Bonù MD , Giorgio Facheris MD , Stefano Maria Magrini , Luigi Spiazzi , Michela Buglione","doi":"10.1016/j.adro.2024.101696","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Multiple myeloma (MM) tends to develop resistance to systemic therapy through multiple mechanisms that might as well induce radioresistance, as suggested by preclinical studies. The aim of the present analysis was to elucidate whether the number of systemic treatment lines received prior to radiation therapy (RT) might confer radioresistance and influence local response.</div></div><div><h3>Methods and Materials</h3><div>This single-center retrospective study enrolled patients who received RT for MM at our institution between January 1, 2005, and January 31, 2023. Information regarding RT, systemic therapy, and characteristics of the patients and disease were retrieved from medical records. The primary outcome for this analysis was radiologic local response at 6 months after RT, according to RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) or PERCIST 1.0 (Positron Emission Tomography Response Criteria in Solid Tumors) criteria. The secondary outcome was toxicity reported during the RT course.</div></div><div><h3>Results</h3><div>Data from 665 MM lesions from 366 patients were analyzed. Data regarding local response at 6 months were available for 217 lesions, reporting 29 complete responses (13.4%), 141 partial responses (65%), 42 stable diseases (19.4%), and only 5 disease progressions (2.3%). The number of previous systemic treatment lines had no impact on radiologic response at 6 months (<em>p</em> = .721). RT BED<sub>10</sub> (Biologically Effective Dose) had a significant impact on response at 6 months (<em>p</em> = .007). The toxicity profile was optimal, as grade > 2 events during RT were reported only in 0.9% of cases.</div></div><div><h3>Conclusions</h3><div>In this large retrospective cohort of MM patients, the number of systemic treatment lines administered before RT had no impact on the local response, confuting concerns of cross-resistance raised by multiple preclinical studies. Disease control after RT was optimal, and instances of severe toxicities during treatment were rare.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 3","pages":"Article 101696"},"PeriodicalIF":2.2000,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Radiation Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2452109424002598","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Multiple myeloma (MM) tends to develop resistance to systemic therapy through multiple mechanisms that might as well induce radioresistance, as suggested by preclinical studies. The aim of the present analysis was to elucidate whether the number of systemic treatment lines received prior to radiation therapy (RT) might confer radioresistance and influence local response.

Methods and Materials

This single-center retrospective study enrolled patients who received RT for MM at our institution between January 1, 2005, and January 31, 2023. Information regarding RT, systemic therapy, and characteristics of the patients and disease were retrieved from medical records. The primary outcome for this analysis was radiologic local response at 6 months after RT, according to RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) or PERCIST 1.0 (Positron Emission Tomography Response Criteria in Solid Tumors) criteria. The secondary outcome was toxicity reported during the RT course.

Results

Data from 665 MM lesions from 366 patients were analyzed. Data regarding local response at 6 months were available for 217 lesions, reporting 29 complete responses (13.4%), 141 partial responses (65%), 42 stable diseases (19.4%), and only 5 disease progressions (2.3%). The number of previous systemic treatment lines had no impact on radiologic response at 6 months (p = .721). RT BED₁₀ (Biologically Effective Dose) had a significant impact on response at 6 months (p = .007). The toxicity profile was optimal, as grade > 2 events during RT were reported only in 0.9% of cases.

Conclusions

In this large retrospective cohort of MM patients, the number of systemic treatment lines administered before RT had no impact on the local response, confuting concerns of cross-resistance raised by multiple preclinical studies. Disease control after RT was optimal, and instances of severe toxicities during treatment were rare.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.