The radiation therapy of early stage cutaneous T-cell lymphoma.
Results of different radiotherapy schedules used for early stage (T1-2, N0-1, M0) cutaneous T-cell lymphoma (CTCL) are compared in a series of 45 patients (22 patients treated with high dose total skin electron beam therapy (TSEB) with curative intent, 18 patients treated with palliative radiotherapy, and 5 patients treated with high dose local electron beam). At 3, 5, and 10 years after diagnosis the high dose TSEB treatment group had a probability of overall survival of 91%, 86%, and 75%, respectively, compared with 94%, 88%, and 88% for the palliative treatment group. The complete response (CR) rate for the high dose TSEB treatment group was 82% (18/22), compared with a 57% (4/7) complete response rate for seven patients in the palliative group who received low dose TSEB (less than 25 Gy in 6-7 weeks) followed by daily application of topical mechlorethamine hydrochloride (HN2). However, the probability of continued remission at 3, 5, and 10 years was 44%, 44%, and 33%, respectively, for the high dose TSEB group and 25%, 25%, and 0%, respectively, for the low dose TSEB + HN2 group. The median disease-free survival was 17.5 months for the high dose TSEB group versus 5.5 months for the low dose TSEB + HN2 group. The five patients who were treated with high doses of local electrons to a single local field had an overall survival rate of 80%, a median survival rate of 64 months, and a median length of continued remission of 31 months. These results indicate that high-dose electron beam can result in long-term disease-free survival in patients with localized and limited extent skin involvement with cutaneous T-cell lymphoma.
Micaily
B
B
Department of Radiation Oncology and Nuclear Medicine, Hahnemann University, Philadelphia, PA 19102-1192.
Moser
C
C
Vonderheid
E C
EC
Koprowski
C
C
Lightfoot
D
D
Markoe
A
A
Brady
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D010166:Palliative Care; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy*; D015996:Survival Rate