title: Results of a 5-week schedule of modern total skin electron beam radiation therapy.
abstract: OBJECTIVE
  To report the outcomes of a 5-week schedule of total skin electron beam radiation therapy (TSEB) for mycosis fungoides (MF).
  
  
  METHODS
  Over 5 years, 41 patients with confirmed MF were treated with a modern TSEB technique delivering 30 Gy in 20 fractions over 5 weeks to the whole skin surface. Data were collected prospectively and entered into the skin tumor unit research database. Skin modified skin weighted assessment tool score data were collected to determine response, duration of response, survival, and toxicity. The outcomes were analyzed according to the patient's stage before TSEB, prognostic factors, and adjuvant treatments.
  
  
  RESULTS
  Seventeen patients were stage 1B, 19 were stage IIB, 3 were stage III, and 2 were stage IV. The overall response rate was 95%, with a complete response rate of 51%. Seventy-six percent of patients had relapsed at median follow-up of 18 months. The median time to relapse was 12 months, to systemic therapy was 15 months, and to modified skin weighted assessment tool progression above baseline was 44 months. The complete response rate was 59% in stage IB and 47% in stage IIB patients. The median time to skin relapse was longer in stage IB compared with stage IIB, 18 months versus 9 months. The median time to systemic therapy was longer in stage IB compared with stage IIB, >56 months versus 8 months. The median overall survival was 35 months: >56 months for stage IB, 25 months for stage IIB, 46 months for stage III, and 23.5 months for stage IV. Fifteen patients received adjuvant psoralen + ultraviolet A treatment with no difference seen in the time to relapse.
  
  
  CONCLUSIONS
  This 5-week schedule of TSEB for MF has a high response rate with comparable duration of response to other regimens. Future studies are needed to find adjuvant and combination treatments to improve the duration of response.
authors.affiliation: St Johns Institute of Dermatology, Guys and St Thomas Hospital, London, United Kingdom. stephen.morris@gstt.nhs.uk
authors.forename: Stephen Lloyd
authors.initials: SL
authors.lastname: Morris
authors.forename: Mark
authors.initials: M
authors.lastname: McGovern
authors.forename: Sally
authors.initials: S
authors.lastname: Bayne
authors.forename: Mary
authors.initials: M
authors.lastname: Wain
authors.forename: Fiona
authors.initials: F
authors.lastname: Child
authors.forename: Sean
authors.initials: S
authors.lastname: Whittaker
mesh_terms: D019583:Dose Fractionation, Radiation; D004583:Electrons; D005260:Female; D006801:Humans; D008297:Male; D009182:Mycosis Fungoides / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000379:methods*