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Total Skin Electron Beam for Primary Cutaneous T-cell Lymphoma
- Source :
- International Journal of Radiation Oncology*Biology*Physics. 93:1077-1086
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Purpose Recent trials with low-dose total skin electron beam (TSEB) therapy demonstrated encouraging results for treating primary cutaneous T-cell lymphoma (PCTCL). In this study, we assessed the feasibility of different radiation doses and estimated survival rates of different pathologic entities and stages. Methods and Materials We retrospectively identified 45 patients with PCTCL undergoing TSEB therapy between 2000 and 2015. Clinical characteristics, treatment outcomes, and toxicity were assessed. Results A total of 49 courses of TSEB therapy were administered to the 45 patients. There were 26 pathologically confirmed cases of mycosis fungoides (MF) lymphoma, 10 cases of Sezary syndrome (SS), and 9 non-MF/SS PCTCL patients. In the MF patients, the overall response rate (ORR) was 92% (50% complete remission [CR]), 70% ORR in SS patients (50% CR), and 89% ORR in non-MF/SS patients (78% CR). The ORR for MF/SS patients treated with conventional dose (30-36 Gy) regimens was 92% (63% CR) and 75% (25% CR) for low-dose ( P =.09). In MF patients, the overall survival (OS) was 77 months with conventional dose regimens versus 14 months with low-dose regimens ( P =.553). In SS patients, the median OS was 48 versus 16 months ( P =.219), respectively. Median event-free survival (EFS) for MF in conventional dose patients versus low-dose patients was 15 versus 8 months, respectively ( P =.264) and 19 versus 3 months for SS patients ( P =.457). Low-dose regimens had shorter treatment time ( P =.009) and lower grade 2 adverse events ( P =.043). A second TSEB course was administered in 4 MF patients with 100% ORR. There is a possible prognostic impact of supplemental/boost radiation ( P P P =.021) were detected. Conclusions TSEB therapy is an efficacious treatment modality in the treatment of several forms of cutaneous T-cell lymphoma. There is a nonsignificant trend to higher and longer clinical benefit for MF and SS patients receiving conventional dose. Low-dose TSEB regimens are well tolerated and achieve short-term palliation.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Skin Neoplasms
Electrons
Gastroenterology
Disease-Free Survival
Mycosis Fungoides
Internal medicine
medicine
Humans
Sezary Syndrome
Radiology, Nuclear Medicine and imaging
Adverse effect
Aged
Retrospective Studies
Aged, 80 and over
Analysis of Variance
Mycosis fungoides
Lower grade
Radiation
business.industry
Complete remission
Radiotherapy Dosage
Retrospective cohort study
Middle Aged
medicine.disease
Primary cutaneous T-cell lymphoma
Lymphoma, T-Cell, Cutaneous
Surgery
Lymphoma
Oncology
Toxicity
Feasibility Studies
Female
business
Subjects
Details
- ISSN :
- 03603016
- Volume :
- 93
- Database :
- OpenAIRE
- Journal :
- International Journal of Radiation Oncology*Biology*Physics
- Accession number :
- edsair.doi.dedup.....74d68c99e6378fb8194b27d478de97af