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.
Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Karen J
KJ
Neelis
Erik C
EC
Schimmel
Maarten H
MH
Vermeer
Nancy J
NJ
Senff
Rein
R
Willemze
Evert M
EM
Noordijk
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