title: Radiotherapy of splenomegaly : a palliative treatment option for a benign phenomenon in malignant diseases.
abstract: OBJECTIVE
  Since the 20(th) century, radiotherapy (RT) has been used for treatment of symptomatic splenomegaly (SM). SM occurs in association with hematologic disorders. The purpose of this analysis was to determine the indication, treatment concepts, and efficiency of RT.
  
  
  METHODS
  Clinical features, treatment concepts, and outcome data during the past 20 years were analyzed. Endpoints were pain relief, symptomatic and hematological response, and treatment-related side effects.
  
  
  RESULTS
  From 1989-2009, a total of 122 patients received 246 RT courses because of symptomatic SM. Overall 31 patients had chronic myelogenous leukemia (CML), 37 had chronic lymphocytic leukemia (CLL), 23 had osteomyelofibrosis (OMF), 17 had polycythemia vera (PV), 5 had acute myelogenous leukemia, 4 had idiopathic thrombocytopenic purpura (ITP), 3 had non-Hodgkin lymphoma (NHL), and 2 had multiple myeloma (MM). Patients were treated with (60)Co gamma rays or 5-15MV photons. The fraction size ranged from 10-200 cGy and the total dose per treatment course from 30-1600 cGy. Significant pain relief was achieved for 74.8% of the RT courses given for splenic pain. At least 50% regression was attained for 77% of the RT courses given for SM. 36 patients died within 2 months due to the terminal nature of their disease. Of the RT courses applied for cytopenia, 73.6% achieved a significant improvement of hematological parameters and reduction of transfusion need. Notable hematologic toxicities were reported < EORTC/RTOG II°.
  
  
  CONCLUSIONS
  The present analysis documents the efficacy of RT. In addition, RT as a palliative treatment option for symptomatic SM should not be forgotten.
authors.affiliation: Department of Radiation Oncology, University of Cologne, Cologne, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Kriz
authors.forename: Oliver
authors.initials: O
authors.lastname: Micke
authors.forename: Frank
authors.initials: F
authors.lastname: Bruns
authors.forename: Uwe
authors.initials: U
authors.lastname: Haverkamp
authors.forename: Ralph
authors.initials: R
authors.lastname: Mücke
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schäfer
authors.forename: Heinrich
authors.initials: H
authors.lastname: Seegenschmiedt
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Müller
authors.forename: Hans Theodor
authors.initials: HT
authors.lastname: Eich
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003037:Cobalt Radioisotopes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010166:Palliative Care; D010257:Paraneoplastic Syndromes / Q000401:mortality / Q000532:radiotherapy*; D011867:Radioisotope Teletherapy / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D013163:Splenomegaly / Q000401:mortality / Q000532:radiotherapy*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003037:Cobalt Radioisotopes