Combined modality therapy for cutaneous T-cell lymphoma.
BACKGROUND
Cutaneous T-cell lymphoma (CTCL) may respond to many therapies, but long-term disease-free survival is uncommon. Patients with advanced disease have a median survival of approximately 3 years.


OBJECTIVE
Our purpose was to combine known effective agents sequentially to determine whether we could achieve remission in more patients or for longer duration.


METHODS
Patients with mycosis fungoides (n = 23) or Sézary syndrome (n = 5) were treated with 4 months of recombinant interferon alfa together with isotretinoin, followed by total skin electron beam therapy alone (for stage I to II disease) or preceded by chemotherapy (for stage III to IV disease). Maintenance therapy consisted of interferon for 1 year and topical nitrogen mustard for 2 years.


RESULTS
Twenty-eight patients were treated. The overall response rate (complete and partial remissions) was 82%. Although the median duration of remission was 5 months in patients with stage III to IV disease, two patients remain in complete remission at 39 + and 46 + months. In patients with stage I to II disease the median duration of remission has not been reached at a median follow-up of 18 months. Five patients, all with stage III to IV disease, have died. Overall, the regimen was well tolerated with one treatment-related death from neutropenic sepsis.


CONCLUSIONS
Combined modality therapy may be effective for the treatment of CTCL with similar response rates to other current therapies.
Duvic
M
M
Department of Medical Specialties, University of Texas, M. D. Anderson Cancer Center, Houston 77030, USA.
Lemak
N A
NA
Redman
J R
JR
Eifel
P J
PJ
Tucker
S L
SL
Cabanillas
F F
FF
Kurzrock
R
R
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002423:Cause of Death; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007370:Interferon Type I / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000628:therapy*; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D011994:Recombinant Proteins; D012074:Remission Induction; D012751:Sezary Syndrome / Q000628:therapy*; D012878:Skin Neoplasms / Q000628:therapy*; D015996:Survival Rate
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D007370:Interferon Type I; D007641:Keratolytic Agents; D011994:Recombinant Proteins; D008466:Mechlorethamine; D015474:Isotretinoin