Multiple Myeloma Coverage from Every Angle

ASTRO 2020: Low-Dose Radiotherapy for Painful Osseous Lesions in Patients With Myeloma

By: Joseph Cupolo
Posted: Monday, November 9, 2020

In a recent presentation during the virtual edition of the American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 1108), a team of investigators, led by Jeremy Gordon Price, MD, PhD, of Duke University Medical Center, Durham, North Carolina, reported that low-dose palliative radiotherapy effectively mitigates painful bony lesions associated with multiple myeloma. A total of 34 patients with 70 treated lesions were included in the study. It should be noted that osteolytic lesions are present in 75% of patients with multiple myeloma.

“Low-dose radiotherapy palliation could permit patients to proceed quickly to systemic therapy by minimizing treatment duration and acute side effects,” the investigators noted.

A total of 24 patients (49 lesions) were treated with higher-dose radiotherapy and 10 patients (21 lesions) with low-dose radiotherapy. The high-dose therapy's median dose was 20 Gy, compared with 4 Gy for the low-dose therapy. The investigators retrospectively identified all patients with multiple myeloma treated with radiotherapy for painful bone lesions at either a tertiary care academic center or Veterans Affairs affiliate hospital. All patients underwent CT simulation and were treated with standard palliative fields. Patients were grouped into the low-dose cohort if the equieffective dose was less than 12 Gy, with all others comprising the high-dose cohort.

The investigators analyzed the rates of clinical pain response, differences in acute and late toxicity, duration of pain response, and retreatment rates between the two groups. The overall clinical pain response rate was 97%; for those receiving high-dose radiotherapy, it was 98%, and for patients receiving low-dose radiotherapy, it was 95%. Acute toxicity appeared to be greater with the high-dose therapy than low-dose therapy (24.5% vs. 9.5%).

According to the study authors, their data support prospective comparisons between these two radiotherapy approaches in this patient population.

Disclosure: For full disclosures of the study authors, visit

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