Second primary tumors in mycosis fungoides patients: experience at the Northern Israel Oncology Center (1979-2002).
OBJECTIVE
Mycosis fungoides (MF) patients enjoy longstanding remissions following total skin electron irradiation (TSEI) but run the risk of developing secondary malignancies. Our purpose was to report our experience with the phenomenon of secondary malignancies in MF patients.


METHODS
From 1979 to 2002, 84 patients with biopsy-proven MF were referred to our department for TSEI, using the modified Christie Hospital translational technique until 1992 and the Stanford technique after 1992. Median total dose was 32 Gy (range 16-44) Christie; 30 Gy (range 15-36) Stanford. Underdosed areas were boosted with a median total dose of 10-20 Gy.


RESULTS
During a median follow-up of 73 months (range 2-191) from the end of the TSEI, 12 (15%) patients developed 17 second primary tumors within the irradiated areas and 6 patients developed 7 second primary tumors, either simultaneously with the newly diagnosed MF or prior to introduction of radiation therapy.


CONCLUSIONS
The long-term prognosis was related solely to the second primary. Due to excellent long-lasting response rates following TSEI coupled with long-term survival, and the prognosis mainly associated to the stage and histology of the second malignancy, physicians should be aware of the possibility of second primary tumors.
Stein
M E
ME
Department of Oncology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. m_stein@rambam.health.gov.il
Anacak
Y
Y
Zaidan
J
J
Drumea
K
K
Gez
E
E
Bar-Deroma
R
R
Chetwer
L
L
Kuten
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology* / Q000532:radiotherapy*; D016609:Neoplasms, Second Primary / Q000473:pathology*; D011379:Prognosis; D012878:Skin Neoplasms / Q000473:pathology* / Q000532:radiotherapy*