Would involved site radiation therapy be recommended in a patient with POEMS syndrome (including 3 lytic spinal lesions and a liver plasmacytoma) whose myelopathy symptoms worsened after one cycle of CyBorD?

If radiation therapy is offered, what dose and fractionation would you use? Would there be any benefit or risk of concurrent rituximab?

Answer from: Radiation Oncologist at Community Practice

I would swiftly treat this patient with a common schedule, for instance, 5 x 4 Gy. I do not see any risk of concurrent rituximab.