Palliative total skin electron beam therapy (TSEBT) for advanced cutaneous T-cell lymphoma.
Our aim was to analyze the effectiveness of palliative total skin electron beam therapy (TSEBT) in the management of advanced cutaneous T-cell non-Hodgkin's lymphoma (CTCL). Eighteen patients (median age 59 years) with advanced and therapy-refractory CTCL in stages IIB-IV were treated with TSEBT for the first time. The most common histological subtype was Mycosis fungoides (72%). All patients suffered from lymphoma-associated symptoms. Median daily fractions of 1 Gy were administered up to a median total dose of 25 Gy. The median follow-up period was 11 months. Nine patients (50%) achieved a complete response and seven patients (39%) had a limited response. The actuarial one-year progression-free survival was 24%. Four patients (22%) had continuing remission over a median period of six months. Lymphoma associated symptoms were improved in 16 patients (89%). The median overall survival after receiving TSEBT was 12 months, resulting in an actuarial one-year overall survival of 48%. Treatment related acute effects (grade 1 or 2) were observed in all patients during radiation therapy. Transient grade 3 epitheliolyses developed in five patients (28%), late skin effects (grade 1 and 2) in 16 patients (89%), and hypohidrosis was seen in six patients (33%). We conclude that TSEBT is a very efficient and tolerable palliative treatment for patients with advanced CTCL.
Funk
Angela
A
Department of Radio-oncology, University of Heidelberg, Im Neuenheimer Feld 400, D -69120 Heidelberg, Germany.
Hensley
Frank
F
Krempien
Robert
R
Neuhof
Dirk
D
Van Kampen
Michael
M
Treiber
Martina
M
Roeder
Falk
F
Timke
Carmen
C
Herfarth
Klaus
K
Helmbold
Peter
P
Debus
Juergen
J
Bischof
Marc
M
D000328:Adult; D000368:Aged; D004583:Electrons / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017728:Lymphoma, Large-Cell, Anaplastic / Q000473:pathology / Q000532:radiotherapy; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects / Q000379:methods; D012074:Remission Induction; D012189:Retrospective Studies; D012751:Sezary Syndrome / Q000473:pathology / Q000532:radiotherapy; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D015996:Survival Rate; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000009:adverse effects / Q000379:methods