Would you recommend radiation to a painful rib fracture in a patient with multiple myeloma on systemic therapy with ongoing response to treatment?  

It depends if it’s a newly diagnosed MM setting versus relapsed MM setting with a rib fracture. Some possible scenarios: For the ND setting, systemic therapy with adequate pain management early on is preferred. For relapsed setting, if the rib fracture heralded the relapse then systemic th...

This is a common scenario that we see especially in newly diagnosed myeloma, though my management is to start bridging therapy using dexamethasone until the patient can start systemic therapy. Once they start dexamethasone, I request to contact the patient the day after to discuss if the pain has im...

My practice for multiple myeloma small rib lesions/tumors is 8 Gy x 1. The toxicity is negligible, logistics minimal, and treatment does not interfere with any existing systemic therapies and can be given concurrently. There are pending data that will be presented at this upcoming ASTRO that support...

I am starting to use single/2 day stereotactic RT developed at our center on protocol for single painful lesions in late advanced myeloma cases, where the systemic disease is or is not well controlled. In late disease, it is less clear whether the next line of therapy will be effective, or if additi...

Knowing there are decades of reports on the palliation of bone pain with the use of short courses of radiation, it would not be wrong to do so. However, knowing that there can be significant symptomatic relief with the onset of initial therapy, it would also be reasonable to wait. A scenario where ...