title: Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma.
abstract: BACKGROUND
  A moderate dose of radiation is the recommended treatment for solitary plasmacytoma (SP), but there is controversy over the role of surgery. Our study aimed at comparing different treatment modalities in the management of SP.
  
  
  METHODS
  Data from 38 consecutive patients with solitary plasmacytoma, including 16 with bone plasmacytoma and 22 with extramedullary plasmacytoma, were retrospectively reviewed. 15 patients received radiotherapy alone; 11 received surgery alone, and 12 received both. The median radiation dose was 50Gy. All operations were performed as radical resections. Local progression-free survival (LPFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS) and overall survival (OS) were calculated and outcomes of different therapies were compared.
  
  
  RESULTS
  The median follow-up time was 55 months. 5-year LPFS, MMFS, PFS and OS were 87.0%, 80.9%, 69.8% and 87.4%, respectively. Univariate analysis revealed, compared with surgery alone, radiotherapy alone was associated with significantly higher 5-year LPFS (100% vs 69.3%, p=0.016), MMFS (100% vs 51.4%, p=0.006), PFS (100% vs 33.7%, p=0.0004) and OS (100% vs 70%, p=0.041).
  
  
  CONCLUSIONS
  Radiotherapy alone can be considered as a more effective treatment for SP over surgery. Whether a combination of radiotherapy and surgery improves outcomes requires further study.
authors.affiliation: Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China E-mail : zhangyj@sysucc.org.cn.
authors.forename: Qi-Wen
authors.initials: QW
authors.lastname: Li
authors.forename: Shao-Qing
authors.initials: SQ
authors.lastname: Niu
authors.forename: Han-Yu
authors.initials: HY
authors.lastname: Wang
authors.forename: Ge
authors.initials: G
authors.lastname: Wen
authors.forename: Yi-Yang
authors.initials: YY
authors.lastname: Li
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Xia
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010954:Plasmacytoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D011878:Radiotherapy / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate