Low-dose total skin electron beam therapy as an effective modality to reduce disease burden in patients with mycosis fungoides: results of a pooled analysis from 3 phase-II clinical trials

J Am Acad Dermatol. 2015 Feb;72(2):286-92. doi: 10.1016/j.jaad.2014.10.014. Epub 2014 Dec 2.

Abstract

Background: Standard-dose (36-Gy) total skin electron beam therapy (TSEBT) is a highly effective treatment in mycosis fungoides. However, the regimen is time-intensive and may be associated with significant toxicity.

Objective: We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT.

Methods: Data from 3 clinical trials using low-dose (12-Gy) TSEBT were pooled. In all trials, TSEBT-naïve patients with stage IB to IIIA mycosis fungoides were treated with TSEBT (12 Gy, 1 Gy per fraction over 3 weeks). The primary end point was clinical response rate. Secondary end points included time to response and duration of clinical benefit.

Results: In all, 33 patients enrolled. Eighteen were male; stages were 22 IB, 2 IIA, 7 IIB, and 2 IIIA. Overall response rate was 88% (29/33), including 9 patients with complete response. Median time to response was 7.6 weeks (3-12.4 weeks). Median duration of clinical benefit was 70.7 weeks (95% confidence interval 41.8-133.8 weeks). Toxicities from TSEBT were mild and reversible.

Limitations: Conclusions are limited because of the small number of patients.

Conclusions: Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with mycosis fungoides, which could be administered safely multiple times during the course of a patient's disease with acceptable toxicity profile.

Keywords: T-cell lymphoma; cutaneous lymphoma; low-dose total skin electron beam therapy; radiotherapy; total skin electron beam therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Trials, Phase II as Topic
  • Cost of Illness
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mycosis Fungoides / pathology
  • Mycosis Fungoides / radiotherapy*
  • Neoplasm Staging
  • Radiodermatitis / etiology
  • Radiotherapy Dosage
  • Randomized Controlled Trials as Topic
  • Remission Induction
  • Retrospective Studies
  • Skin Neoplasms / pathology
  • Skin Neoplasms / radiotherapy*
  • Treatment Outcome
  • Whole-Body Irradiation* / adverse effects