title: Total skin electron beam therapy as palliative treatment for cutaneous manifestations of advanced, therapy-refractory cutaneous lymphoma and leukemia.
abstract: BACKGROUND
  To retrospectively access the outcome and toxicity of a total skin electron beam therapy (TSEBT) in patients with cutaneous lymphoma (CL) or leukemia.
  
  
  METHODS
  Treatment results of 25 patients (median age 63 years; 5 female, 20 male) with cutaneous manifestations of advanced and therapy-refractory CL (n = 21; T-cell lymphomas n = 18, B-cell lymphomas n = 3) stage IIB-IV or leukemia (n = 4; AML n = 2, CLL n = 1, PDC n = 1) treated between 1993 and 2010 were reviewed. All patients were symptomatic. The median total dose was 29Gy, applied in 29 fractions of median 1 Gy each.
  
  
  RESULTS
  The median follow-up was 10 months. Palliation was achieved in 23 patients (92%). A clinical complete response was documented in 13 (52%) and a partial response in 10 patients (40%). The median time to skin progression was 5 months (range 1-18 months) and the actuarial one-year progression-free survival 35%. The median overall survival (OS) after the initiation of TSEBT was 10 months (range 1-46 months) and the actuarial one-year OS 45%. TSEBT related acute adverse events (grade 1 or 2) were observed in all patients during the treatment period. An acute grade 3 epitheliolysis developed in eight patients (32%). Long-term adverse events as a hyperpigmentation of the skin (grade 1 or 2) were documented in 19 patients (76%), and a hypohidrosis in seven patients (28%).
  
  
  CONCLUSIONS
  For palliation of symptomatic cutaneous manifestations of advanced cutaneous lymphoma or leukemia, total skin electron beam therapy is an efficient and well tolerated considerable treatment option.
authors: Department of Radiation Oncology, University of Heidelberg, INF 400, Heidelberg, 69120, Germany. Henrik.Hauswald@med.uni-heidelberg.de
authors: Henrik
authors: H
authors: Hauswald
authors: Felix
authors: F
authors: Zwicker
authors: Nathalie
authors: N
authors: Rochet
authors: Matthias
authors: M
authors: Uhl
authors: Frank
authors: F
authors: Hensley
authors: Jürgen
authors: J
authors: Debus
authors: Klaus
authors: K
authors: Herfarth
authors: Marc
authors: M
authors: Bischof
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D004583:Electrons / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016393:Lymphoma, B-Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016410:Lymphoma, T-Cell, Cutaneous / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*