Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma
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...
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Elsevier
2025-03-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109424002598 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Andrea Emanuele Guerini, MD |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-318faf6979a3437d90f100e5307134ff |
| institution | Kabale University |
| issn | 2452-1094 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj-art-318faf6979a3437d90f100e5307134ff2025-01-27T04:22:06ZengElsevierAdvances in Radiation Oncology2452-10942025-03-01103101696Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple MyelomaAndrea Emanuele Guerini, MD0Eneida Mataj, MD1Paolo Borghetti, MD2Luca Triggiani3Ludovica Pegurri, MD4Stefania Nici5Stefano Riga6Alessandra Tucci, MD7Angelo Belotti, MD8Marco Lorenzo Bonù, MD9Giorgio Facheris, MD10Stefano Maria Magrini11Luigi Spiazzi12Michela Buglione13Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy; Corresponding author: Eneida Mataj, MDDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyMedical Physics Department, ASST Spedali Civili Hospital, Brescia, ItalyMedical Physics Department, ASST Spedali Civili Hospital, Brescia, ItalyDepartment of Haematology, ASST Spedali Civili Hospital, Brescia, ItalyDepartment of Haematology, ASST Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyDipartimento di Specialità Medico-Chirurgiche, Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT), Scienze Radiologiche e Sanità Pubblica, University of Brescia, Brescia, ItalyDepartment of Haematology, ASST Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, ItalyPurpose: 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.http://www.sciencedirect.com/science/article/pii/S2452109424002598 |
| spellingShingle | 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 Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma Advances in Radiation Oncology |
| title | Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma |
| title_full | Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma |
| title_fullStr | Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma |
| title_full_unstemmed | Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma |
| title_short | Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma |
| title_sort | impact of the number of administered systemic treatment lines on local response to radiation therapy for multiple myeloma |
| url | http://www.sciencedirect.com/science/article/pii/S2452109424002598 |
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