Radiotherapy

Radiotherapy has been utilized in the management of patients with plasma cell malignancies for much of the twentieth century and continues today. It has been estimated that radiotherapy will be required for up to 70% of patients with multiple myeloma at some point in the course of their disease,1 and it is the primary treatment modality for patients with solitary extramedullary or bone plasmacytomas (see Chapter 25). The radiosensitivity of myeloma has been well established through clinical experience and in laboratory studies. Using a mouse plasma cell tumor model, Bergsagel estimated the D0 (dose required to produce one natural log of cell kill) to be 1.1 Gray (Gy).2 This chapter will review the current roles of radiotherapy in the palliative management of multiple myeloma and as part of the conditioning regimens for bone marrow transplant for multiple myeloma. In addition, the role of radioimmunotherapy will be discussed.