Total skin electron beam and total nodal irradiation for treatment of patients with cutaneous T-cell lymphoma.
Sixteen patients with advanced cutaneous T-cell lymphoma (CTCL) with or without lymph node involvement, but without evidence of extranodal manifestations, were treated with a combination of total skin electron beam therapy (TSEB) and total nodal irradiation (TNI). Fourteen (87%) patients achieved a complete response (CR) lasting from 1 to 84+ months (median, 8+ months) from the completion of treatment. The best results occurred in 6 patients with pretumorous intracutaneous CTCL (Stages IB and IIA) where the CR has lasted in all patients from 8 to 84+ months (median about 27+ months). Conversely, a long-term CR occurred in only one of five patients with tumor-phase intracutaneous CTCL (Stage IIB) and in none of the 5 patients with histopathologically proven nodal involvement (Stage IVA). Radiotherapy was well tolerated with the major toxicity being bone marrow suppression. We conclude that combined TSEB and TNI is a relatively safe and effective treatment for patients with CTCL prior to the development of lymph node involvement. Long-term follow-up is needed to assess the curative potential of this treatment.
D000328:Adult; D000368:Aged; D004583:Electrons; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000528:radiation effects; D008223:Lymphoma / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011882:Radiotherapy, High-Energy; D012867:Skin / Q000528:radiation effects; D012878:Skin Neoplasms / Q000532:radiotherapy*; D013601:T-Lymphocytes