Combined treatment with oral etretinate and electron beam therapy in patients with cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome).
BACKGROUND
Total skin irradiation for early-stage mycosis fungoides produces clinical remission in 90% of patients, but the median duration of remission is only 2 to 4 years. Etretinate has proven efficacy in advanced mycosis fungoides. Its potential as adjuvant therapy to radiation could be limited by toxicity from the combination.


OBJECTIVE
Our purpose was to determine whether oral etretinate at 1 mg/kg can be combined with 35 Gy of radiation without intensifying or prolonging the radiation reaction and to determine the relapse-free survival rate.


METHODS
Twenty-three patients began etretinate on day one of radiation and the dose was reduced for nose bleeds, dry skin, or hyperlipidemia. During the reaction skin toxicity questionnaires were completed weekly. Nine concurrent patients receiving only radiation completed identical forms.


RESULTS
Etretinate did not intensify the skin reaction but did prolong it by 2 weeks. At a median follow-up of 2 years the relapse-free survival rate in complete responders was similar to stage-matched concurrent and historic control subjects.


CONCLUSIONS
Both radiation and etretinate can be given together with acceptable toxicity and without compromising either therapy.
Jones
G
G
Hamilton Regional Cancer Centre, Henderson Clinic, Ontario, Canada.
McLean
J
J
Rosenthal
D
D
Roberts
J
J
Sauder
D N
DN
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005050:Etretinate / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*
D005050:Etretinate