title: Low-dose (10-Gy) total skin electron beam therapy for cutaneous T-cell lymphoma: an open clinical study and pooled data analysis.
abstract: OBJECTIVE
  Cutaneous T-cell lymphomas (CTCLs) are dominated by mycosis fungoides (MF) and Sézary syndrome (SS), and durable disease control is a therapeutic challenge. Standard total skin electron beam therapy (TSEBT) is an effective skin-directed therapy, but the possibility of retreatments is limited to 2 to 3 courses in a lifetime due to skin toxicity. This study aimed to determine the clinical effect of low-dose TSEBT in patients with MF and SS.
  
  
  METHODS
  In an open clinical study, 21 patients with MF/SS stages IB to IV were treated with low-dose TSEBT over <2.5 weeks, receiving a total dose of 10 Gy in 10 fractions. Data from 10 of these patients were published previously but were included in the current pooled data analysis. Outcome measures were response rate, duration of response, and toxicity.
  
  
  RESULTS
  The overall response rate was 95% with a complete cutaneous response or a very good partial response rate (<1% skin involvement with patches or plaques) documented in 57% of the patients. Median duration of overall cutaneous response was 174 days (5.8 months; range: 60-675 days). TSEBT-related acute adverse events (grade 1 or 2) were observed in 60% of patients.
  
  
  CONCLUSIONS
  Low-dose (10-Gy) TSEBT offers a high overall response rate and is relatively safe. With this approach, reirradiation at times of relapse or progression is likely to be less toxic than standard dose TSEBT. It remains to be established whether adjuvant and combination treatments can prolong the beneficial effects of low-dose TSEBT.
authors: Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. Electronic address: mkam0004@bbh.regionh.dk.
authors: Maria R
authors: MR
authors: Kamstrup
authors: Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Robert
authors: R
authors: Gniadecki
authors: Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
authors: Lars
authors: L
authors: Iversen
authors: Department of Dermatology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Lone
authors: L
authors: Skov
authors: Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Peter Meidahl
authors: PM
authors: Petersen
authors: Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Annika
authors: A
authors: Loft
authors: Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Lena
authors: L
authors: Specht
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004583:Electrons / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology / Q000532:radiotherapy*; D012008:Recurrence; D019233:Retreatment / Q000009:adverse effects / Q000379:methods; D012751:Sezary Syndrome / Q000473:pathology / Q000532:radiotherapy*; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome