title: Splenic irradiation as palliative treatment for symptomatic splenomegaly due to secondary myelofibrosis: a multi-institutional experience.
abstract: OBJECTIVE
  To evaluate the impact of splenic irradiation as a palliative treatment for symptomatic splenomegaly due to secondary myelofibrosis.
  
  
  METHODS
  Seventeen patients with chronic myelogenous leukemia and 3 with idiopathic polycythaemia presented with splenomegaly, splenic pain and anemia. Due to symptomatic splenomegaly, despite first-line treatment, the patients underwent splenic irradiation. Two patients received two different schedules of external radiotherapy (580 cGy in 5 fractions and 600 cGy in 6 fractions). Eight patients received 980 cGy in 14 fractions. Ten patients received two courses of 360 cGy in 6 fractions, 3 months apart. Median follow-up was 12 months post irradiation.
  
  
  RESULTS
  The patients showed excellent response to treatment one month post-radiotherapy, while treatment was well tolerated without severe toxicity. The dimensions of the spleen decreased significantly. Pain-related Visual Analogue Score (VAS) regressed after completion of irradiation. During 12-month follow-up all patients maintained the benefit of radiotherapy.
  
  
  CONCLUSIONS
  This study indicates that splenic irradiation could be a safe and effective palliative treatment for symptomatic splenomegaly due to secondary myelofibrosis.
authors.affiliation: Department of Radiation Oncology, AHEPA Hospital, Aristoteles University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Kiki
authors.initials: K
authors.lastname: Pistevou-Gombaki
authors.forename: Anna
authors.initials: A
authors.lastname: Zygogianni
authors.forename: Ioanna
authors.initials: I
authors.lastname: Kantzou
authors.forename: George
authors.initials: G
authors.lastname: Kyrgias
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Mystakidou
authors.forename: John
authors.initials: J
authors.lastname: Kouvaris
authors.forename: Ioannis
authors.initials: I
authors.lastname: Klonizakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsirigotis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Pappa
authors.forename: Marina
authors.initials: M
authors.lastname: Siakantari
authors.forename: Nikos
authors.initials: N
authors.lastname: Eleftheriadis
authors.forename: John
authors.initials: J
authors.lastname: Georgakopoulos
authors.forename: George
authors.initials: G
authors.lastname: Sarris
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kelekis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Kouloulias
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D055728:Primary Myelofibrosis / Q000150:complications*; D013154:Spleen / Q000528:radiation effects*; D013163:Splenomegaly / Q000532:radiotherapy*