Splenic Radiation

Several reports (see Table 49.4) have described the palliative benefit to external beam radiation in improving symptomatic splenomegaly in MMM.88 89 The Mayo Clinic experience88 described a group of 23 MMM patients who received a median radiation course of 277 cGy in a median of eight fractions. An objective decrease in spleen size was noted in 94% of patients; however, 44% of patients experienced posttreatment cytopenias (26% were severe and 13% fatal). In addi tion, splenic radiation seemed to increase morbidity and mortality of subsequent splenectomy when undertaken. Splenic radiation is effective for palliating MMM-associated splenomegaly but should be limited to patients with adequate platelet counts, and to those who are not likely to be splenectomized.

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