Total Skin Electron Beam Therapy for Mycosis Fungoides Revisited With Adjuvant Systemic Therapy

Clin Lymphoma Myeloma Leuk. 2019 Feb;19(2):83-88. doi: 10.1016/j.clml.2018.11.015. Epub 2018 Nov 17.

Abstract

Background: Although standard-dose total skin electron beam therapy (TSEBT) has been thought to provide the greatest clinical benefit for mycosis fungoides, recent studies have shown that low-dose TSEBT may also provide high rates of disease control.

Materials and methods: A retrospective chart review was conducted for patients receiving TSEBT for mycosis fungoides at a single institution from 2009 to 2017. Patients were evaluated for overall survival, progression-free survival, and duration of clinical benefit. Partial response was defined as any documented clinical regression of lesions, whereas complete response was defined as complete resolution of lesions.

Results: Twenty patients were included in the study. Twelve patients received low-dose radiation (≤ 12 Gy), and 8 received standard-dose radiation (> 12 Gy). Response rate was 100% in both groups. The rate of complete response was 38% in the standard-dose group and 25% in the low-dose group. There was no difference in overall survival between the 2 groups (P = .84). There was also no difference in median progression-free survival (P = .95) or duration of clinical benefit (P = .95) between the 2 groups. Of low-dose patients, 33% received immediate systemic therapy, whereas 92% received adjuvant topical or systemic therapy. In the standard-dose group, only 25% received systemic adjuvant therapy, and 63% received adjuvant topical or systemic therapy.

Conclusion: Low-dose TSEBT with adjuvant therapy results in adequate symptom palliation, comparable to standard-dose TSEBT. Low-dose TSEBT should be considered a standard treatment option in this population.

Keywords: Cutaneous T-cell lymphoma; Low-dose total skin electron therapy; MF; Radiation therapy; TSEBT.

MeSH terms

  • Chemotherapy, Adjuvant / methods*
  • Female
  • Humans
  • Male
  • Mycosis Fungoides / drug therapy*
  • Mycosis Fungoides / pathology
  • Mycosis Fungoides / therapy*
  • Progression-Free Survival
  • Retrospective Studies
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Tomography, X-Ray Computed / methods*