title: Low-dose total skin electron beam therapy as an effective modality to reduce disease burden in patients with mycosis fungoides: results of a pooled analysis from 3 phase-II clinical trials.
abstract: BACKGROUND
  Standard-dose (36-Gy) total skin electron beam therapy (TSEBT) is a highly effective treatment in mycosis fungoides. However, the regimen is time-intensive and may be associated with significant toxicity.
  
  
  OBJECTIVE
  We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT.
  
  
  METHODS
  Data from 3 clinical trials using low-dose (12-Gy) TSEBT were pooled. In all trials, TSEBT-naïve patients with stage IB to IIIA mycosis fungoides were treated with TSEBT (12 Gy, 1 Gy per fraction over 3 weeks). The primary end point was clinical response rate. Secondary end points included time to response and duration of clinical benefit.
  
  
  RESULTS
  In all, 33 patients enrolled. Eighteen were male; stages were 22 IB, 2 IIA, 7 IIB, and 2 IIIA. Overall response rate was 88% (29/33), including 9 patients with complete response. Median time to response was 7.6 weeks (3-12.4 weeks). Median duration of clinical benefit was 70.7 weeks (95% confidence interval 41.8-133.8 weeks). Toxicities from TSEBT were mild and reversible.
  
  
  CONCLUSIONS
  Conclusions are limited because of the small number of patients.
  
  
  CONCLUSIONS
  Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with mycosis fungoides, which could be administered safely multiple times during the course of a patient's disease with acceptable toxicity profile.
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California. Electronic address: rhoppe@stanford.edu.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Hoppe
authors.affiliation: Department of Dermatology, Stanford Cancer Institute, Stanford, California.
authors.forename: Cameron
authors.initials: C
authors.lastname: Harrison
authors.affiliation: Department of Dermatology, Stanford Cancer Institute, Stanford, California.
authors.forename: Mahkam
authors.initials: M
authors.lastname: Tavallaee
authors.affiliation: Department of Dermatology, Stanford Cancer Institute, Stanford, California.
authors.forename: Sameer
authors.initials: S
authors.lastname: Bashey
authors.affiliation: Department of Dermatology, Stanford Cancer Institute, Stanford, California; Department of Pathology, Stanford Cancer Institute, Stanford, California.
authors.forename: Uma
authors.initials: U
authors.lastname: Sundram
authors.affiliation: Department of Dermatology, Stanford Cancer Institute, Stanford, California.
authors.forename: Shufeng
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
authors.forename: Lynn
authors.initials: L
authors.lastname: Million
authors.affiliation: Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Bouthaina
authors.initials: B
authors.lastname: Dabaja
authors.affiliation: Department of Dermatology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gangar
authors.affiliation: Department of Dermatology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Duvic
authors.affiliation: Department of Dermatology, Stanford Cancer Institute, Stanford, California.
authors.forename: Youn H
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017322:Clinical Trials, Phase II as Topic; D017281:Cost of Illness; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011855:Radiodermatitis / Q000209:etiology; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000009:adverse effects
keywords: T-cell lymphoma; cutaneous lymphoma; low-dose total skin electron beam therapy; radiotherapy; total skin electron beam therapy