title: Acute toxicity and risk of infection during total skin electron beam therapy for mycosis fungoides.
abstract: BACKGROUND
  Detailed rates of acute toxicity and skin infection during total skin electron beam therapy (TSEBT) for mycosis fungoides have not been reported in a large, modern series.
  
  
  OBJECTIVE
  We sought to demonstrate the rates of acute toxicity and skin infection during TSEBT.
  
  
  METHODS
  We retrospectively reviewed 89 consecutive courses of TSEBT. In all, 82 courses were prescribed a dose of 30 to 36 Gy and were included in the toxicity analysis. We recorded the types and grades of acute treatment toxicities and the incidence of infection during TSEBT for comparison with the previously documented baseline incidence of infection in mycosis fungoides.
  
  
  RESULTS
  The most common toxicities included erythema/desquamation (76%), blisters (52%), hyperpigmentation (50%), and skin pain (48%). The worst reported toxicity grade per patient was grade 1 in 21%, grade 2 in 67%, and grade 3 in 10%, with no grade 4 or 5 toxicities. According to the previously reported rate, a total of 2.4 infections were expected for our cohort at baseline. The number with skin infection was 26 (32%) (relative risk 10.8, P < .01), and of these, 12 (15%) were culture confirmed (relative risk 5.0, P < .01).
  
  
  CONCLUSIONS
  This was a retrospective study design.
  
  
  CONCLUSIONS
  The risk of cutaneous infection is significant during TSEBT.
authors.affiliation: Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Shane
authors.initials: S
authors.lastname: Lloyd
authors.forename: Zhe
authors.initials: Z
authors.lastname: Chen
authors.forename: Francine M
authors.initials: FM
authors.lastname: Foss
authors.forename: Michael
authors.initials: M
authors.lastname: Girardi
authors.forename: Lynn D
authors.initials: LD
authors.lastname: Wilson
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D003881:Dermatomycoses / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D004583:Electrons; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009182:Mycosis Fungoides / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011855:Radiodermatitis / Q000175:diagnosis / Q000453:epidemiology*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D017192:Skin Diseases, Bacterial / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D014916:Whole-Body Irradiation / Q000009:adverse effects*
keywords: AJCC; American Joint Committee on Cancer; ECP; MF; OR; RT; TSEBT; extracorporeal photopheresis; infection; mycosis fungoides; odds ratio; race; radiation therapy; total skin electron beam therapy; toxicity