title: Additional courses of total skin electron beam therapy in the treatment of patients with recurrent cutaneous T-cell lymphoma.
abstract: BACKGROUND
  Recurrent cutaneous T-cell lymphoma (CTCL) is managed with a variety of modalities. Repeat treatment with additional courses of total skin electron beam therapy (TSEBT) has not been formally evaluated.
  
  
  OBJECTIVE
  Our purpose was to evaluate the efficacy and toxicity of additional TSEBT for recurrent CTCL.
  
  
  METHODS
  A total of 14 patients were treated with TSEBT and received at least two courses, with five of those patients receiving a third course. Patients were offered additional TSEBT if they suffered recurrence despite other therapy if the extent of the recurrence precluded localized radiation. The median follow-up was 36 months.
  
  
  RESULTS
  The median dose for the entire group was 57 Gy. Thirteen patients (93%) achieved a complete response (CR) after the initial course. After the second course, 12 patients (86%) had a CR; of the five patients who underwent a third course, three (60%) achieved a CR. The median disease-free interval after the first course of therapy for those with a CR was 20 months and 11.5 months after the second course. Median survival after the second course was 15 months. All patients had xerosis, pruritus, desquamation, mild erythema, epilation, and anhidrosis of the skin.
  
  
  CONCLUSIONS
  Patients with recurrent CTCL recalcitrant to other forms of therapy or too diffuse for treatment with localized radiation fields are candidates for additional TSEBT. This therapy is effective and well tolerated with an acceptable risk profile.
authors.affiliation: Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06510, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Wilson
authors.forename: P A
authors.initials: PA
authors.lastname: Quiros
authors.forename: S A
authors.initials: SA
authors.lastname: Kolenik
authors.forename: P W
authors.initials: PW
authors.lastname: Heald
authors.forename: I M
authors.initials: IM
authors.lastname: Braverman
authors.forename: R L
authors.initials: RL
authors.lastname: Edelson
authors.forename: B M
authors.initials: BM
authors.lastname: Kacinski
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000209:etiology; D018572:Disease-Free Survival; D004890:Erythema / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007007:Hypohidrosis / Q000209:etiology; D016410:Lymphoma, T-Cell, Cutaneous / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011537:Pruritus / Q000209:etiology; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012867:Skin / Q000528:radiation effects; D012871:Skin Diseases / Q000209:etiology; D017443:Skin Diseases, Eczematous / Q000209:etiology; D012878:Skin Neoplasms / Q000532:radiotherapy*; D015996:Survival Rate; D014916:Whole-Body Irradiation / Q000009:adverse effects