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The median radiation dose was 46 Gy (range 30\u201364). The median follow up was 2.41 years (range 0.33\u201312.33). Ten\u2010year overall survival (OS) and local relapse\u2010free survival (LRFS) were 73% and 94%, respectively. The median progression\u2010free survival (PFS) and multiple myeloma\u2010free survival (MMFS) were 3.5 years and 4.8 years, respectively. On multivariate analyses, the favorable factors were radiotherapy dose of \u226550 Gy and RT + S for PFS and younger age for MMFS. For the patients with medullary plasmacytoma, the favorable factor was younger age for MMFS. RT at \u226550 Gy and RT + S may be favorable prognostic factors on PFS. Younger patients, especially with head\u2010neck lesion and without pre\u2010RT macroscopic tumor, seem to have the best outcome when treated with RT \u00b1 S. Progression to MM remains as the main problem especially for older patients. Am. J. 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