title: Low-dose total skin electron beam therapy as a debulking agent for cutaneous T-cell lymphoma: an open-label prospective phase II study.
abstract: BACKGROUND
  Total skin electron beam therapy (TSEBT) is a powerful treatment for cutaneous T-cell lymphoma (CTCL). Based on the occurrence of relapses with low radiation doses, doses of 30-36Gy are commonly used but most patients still eventually relapse and repeat treatment courses are limited due to the cumulative toxicity. Complete response (CR) rates are about 60-90% for T2-4 stages with a 5-year relapse-free survival of 10-25% for stages IB-III.
  
  
  OBJECTIVE
  To evaluate prospectively the efficacy of low-dose TSEBT (10Gy) in terms of complete cutaneous response rate, overall response rate and response duration in CTCL.
  
  
  METHODS
  Ten patients with stage IB-IV mycosis fungoides (MF) were treated in an open-label manner with four fractions of TSEBT 1Gy weekly to a total skin dose of 10Gy. Treatment responses were assessed at 1 and 3months after treatment and subsequently at least every 6months for a total period of 2years or to disease relapse or progression.
  
  
  RESULTS
  Patients achieved an overall response rate of 90%. The rate of CR or very good partial response (VGPR; <1% skin affected with patches/plaques) was 70%. The median response duration was 5·2months (range 83-469days) for CR and VGPR. Adverse effects were generally mild to moderate in severity.
  
  
  CONCLUSIONS
  Low-dose TSEBT (10Gy) gave a satisfactory response rate and was well tolerated in patients with MF stage IB-IV. Future studies should determine if the combination of low-dose TSEBT with other agents could increase the rate of CR and response duration.
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark. mkam0004@bbh.regionh.dk
authors.forename: M R
authors.initials: MR
authors.lastname: Kamstrup
authors.forename: L M
authors.initials: LM
authors.lastname: Lindahl
authors.forename: R
authors.initials: R
authors.lastname: Gniadecki
authors.forename: L
authors.initials: L
authors.lastname: Iversen
authors.forename: L
authors.initials: L
authors.lastname: Skov
authors.forename: P M
authors.initials: PM
authors.lastname: Petersen
authors.forename: A
authors.initials: A
authors.lastname: Loft
authors.forename: L
authors.initials: L
authors.lastname: Specht
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D004583:Electrons / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000532:radiotherapy*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome