Low-dose palliative radiotherapy for cutaneous B- and T-cell lymphomas.
OBJECTIVE
To determine the efficacy of low-dose palliative radiotherapy for both low-grade malignant cutaneous B-cell lymphomas (CBCLs) and cutaneous T-cell lymphomas (mycosis fungoides).


METHODS
A total of 18 patients with low-grade CBCL (10 primary cutaneous marginal zone B-cell and 8 primary cutaneous follicle center lymphomas) with 44 symptomatic plaques and tumors underwent low-dose (4 Gy in two fractions) local radiotherapy. A total of 31 patients with mycosis fungoides were treated at 82 symptomatic sites, initially with 4 Gy and later with 8 Gy in two fractions.


RESULTS
The complete response rate for CBCL lesions was 72%. Of the 44 B-cell lymphoma lesions, 13 were re-treated to the same site after a median of 6.3 months because of persistent (n = 8) or recurrent (n = 5) symptomatic disease. Of the mycosis fungoides patients treated with 4 Gy in two fractions (17 lesions), 70% failed to respond. Increasing the dose to 8 Gy in two fractions yielded a complete response rate of 92% (60 of 65 lesions). The patients in whom low-dose radiotherapy failed were retreated with 20 Gy in eight fractions.


CONCLUSIONS
Our results have demonstrated that low-dose involved-field radiotherapy induces a high response rate in both CBCL and cutaneous T-cell lymphoma lesions without any toxicity. Therefore, this treatment is now our standard palliative treatment. At progression, it is safe and feasible to apply greater radiation doses.
Neelis
Karen J
KJ
Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Schimmel
Erik C
EC
Vermeer
Maarten H
MH
Senff
Nancy J
NJ
Willemze
Rein
R
Noordijk
Evert M
EM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000145:classification / Q000473:pathology / Q000532:radiotherapy*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology / Q000532:radiotherapy; D016410:Lymphoma, T-Cell, Cutaneous / Q000145:classification / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012878:Skin Neoplasms / Q000145:classification / Q000473:pathology / Q000532:radiotherapy*; D055815:Young Adult