Safety and Feasibility Analysis of a Prospective Trial on Stereotactic Body Radiotherapy for Solitary Bone Plasmacytoma.

BACKGROUND: There have been reports on the use of hypofractionated stereotactic body radiotherapy (SBRT) for bone plasmacytomas, but no prospective data are available. We present the initial analysis of an ongoing prospective protocol on SBRT addressing the feasibility and safety of this treatment for solitary bone plasmacytomas. PATIENTS AND METHODS: A prospective cohort of SBRT for solitary bone plasmacytoma was developed. Patients could receive different doses depending on the index bone, from single fraction for skull base lesions, 24 Gy in 3 fractions for spine lesions, and 30 Gy in 5 fractions for other bones. Overall survival, bone events, local control, and progression to multiple myeloma (MM) were measured and compared to our retrospective cohort of patients treated with conformal standard-dose radiotherapy. Quality of life was assessed via the EORTC QLQ-C30 questionnaire, and toxicities were assessed by the CTCAE v5.0 criteria. After 1 year or the inclusion of 5-10 patients, a feasibility and safety analysis was programmed. RESULTS: Between April 2018 and April 2019, 5 patients were included. All were male, with a median age of 53.1 years. The median follow-up was 21.8 months. No patient had local progression, bone event, or died. Two patients had progressions to MM. The mean survival free of progression to MM was 18.6 months, compared to 19 months in the retrospective cohort; median values were not reached. There were no grade 3 toxicities. CONCLUSION: SBRT for plasmacytoma is safe and feasible. More robust data are awaited.

[The "Fragebogen zur sozialen Integration (FSI)" - psychometric properties and acceptance in patients with hematological malignancies]. / Der Fragebogen zur sozialen Integration (FSI) - Psychometrische Testung und Akzeptanz bei Patienten mit hamatologischen Neoplasien.

OBJECTIVES: The "Fragebogen zur Sozialen Integration (FSI)" is the German adaption of the "Social Adjustment Scale (SAS-SR)". So far, there is no validation of the FSI with regard to patients with cancer. METHODS: The scales leisure time, relatives and partnership of the FSI were test-statistically analyzed in hemato-oncological patients. Concordant validity was examined referring to the German version of the "Social Support Questionnaire (F-Sozu)" and one scale of the "EORTC QLQ-C30". RESULTS: In N = 184 participants, we observed in 1% - 20% missing values for several items. Ceiling effects could be observed for the scales relatives (1.22-2.20), whereby for the scales leisure time (1.27-2.95) and partnership (1.51-3.91) the range was substantially higher. Internal consistency averaged about 0.75 (leisure time, partnership), respectively, 0.69 (relatives). Analyses for validity showed values of -0.23 to -0.50 (F-Sozu) as well as -0.29 to -0.40 (EORTC QLQ-C30), respectively. CONCLUSION: The FSI is a reliable questionnaire to assess social adjustment within hemato-oncological cancer patients. However, psychometric properties in previous studies with psychosomatic patients were better. The high amount of missing values on several items in our study suggests a partial revision of the this instrument would be advisable for use in oncology.

Influence of conditioned natural immunity on tumor growth.

We studied the effect of classical (Pavlovian) conditioning of the natural killer cell response on survival of tumor-bearing mice. Mice were given repeated injections of poly I:C every three days paired with exposure to the odor of camphor for 4 hours. First, we investigated the possible therapeutic effect of repeated exposure to the odor of camphor on the growth of MOPC 104E murine myeloma. The results indicate that camphor alone had no therapeutic effect when the mice were exposed to the odor of camphor after tumor transplantation. We then investigated the effect of repeated exposure to camphor prior to tumor transplantation and subsequent repeated exposure to camphor following tumor transplantation. Again, we observed no therapeutic benefit. In a third experiment, we examined the effect of the conditioned poly I:C response on the growth of the murine myeloma. Animals in the conditioned group had an increase in median survival (day 43, as compared to days 34, 38, 37 of various control groups). Two of these conditioned mice lived more than 120 days and showed early tumor growth, but were free of disease at day 97. During the course of the study conditioned mice received no additional treatment other than being reexposed to camphor every third day.