Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides.
BACKGROUND
Mycosis fungoides (MF) is a non-Hodgkin's T-cell lymphoma of the skin that often begins as limited patches and plaques with slow progression to systemic involvement. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short-term treatment modality for clearing patch-stage MF. The effect of psoralen plus long-wave ultraviolet A (PUVA) in the treatment of patch- and plaque-type MF has also been thoroughly documented.


OBJECTIVE
The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early-stage MF.


METHODS
We analysed the response to treatment, relapse-free survival and irradiation dose in 114 patients with histologically confirmed early-stage MF (stage IA, IB and IIA).


RESULTS
A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient. There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment.


CONCLUSIONS
Our results confirm that phototherapy is a safe, effective and well-tolerated, first-line therapy in patients with early-stage cutaneous T-cell lymphoma, with prolonged disease-free remissions being achieved. It suggests that narrowband UVB is at least as effective as PUVA for treatment of early-stage MF.
Ponte
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Department of Dermatology, Hospital dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. pedrofponte@gmail.com
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Apetato
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy* / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011701:PUVA Therapy / Q000009:adverse effects; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000009:adverse effects