Radiation therapy for bone lesions

Source: Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: April 25, 2025 · Captured 2026-09-09.

Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.

Context: Treatment of Multiple Myeloma / Management and Prevention of Myeloma Bone Disease

Lytic lesions of the spine generally require radiation if any of the following are true:

They are associated with an extramedullary (paraspinal) plasmacytoma.

A painful destruction of a vertebral body occurred.

CT or MRI scans present evidence of spinal cord compression.[161]

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Back pain caused by osteoporosis and small compression fractures of the vertebrae responds best to chemotherapy.

Extensive radiation of the spine or long bones for diffuse osteoporosis may lead to prolonged suppression of hemopoiesis and is rarely indicated.[162]

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Bisphosphonates are useful for slowing or reversing the osteopenia that is common in patients with myeloma.[157]

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Preserved source evidence · Not medical advice