title: CD30+ Cutaneous T Cell Lymphoma: Response to Rotational Total Skin Electron Irradiation.
abstract: BACKGROUND
  Rotational total skin electron irradiation (RTSEI) is an effective therapy for cutaneous T cell lymphoma (CTCL). CD30 expression has been identified as a prognostic factor in CTCL. Therefore, we investigated CD30 status, treatment response, and survival in our cohort of patients with CTCL treated with RTSEI.
  
  
  METHODS
  Patients with CTCL treated with RTSEI (≥30 Gy) between 2000 and 2013 at our institution were identified, and clinical and pathologic data were retrospectively reviewed. Primary outcomes were complete clinical response (CCR; >90% reduction of skin disease burden), relapse-free survival (RFS), and overall survival (OS).
  
  
  RESULTS
  Sixty-eight patients with CTCL treated with RTSEI were identified. Median age at diagnosis was 51 years with median follow-up of 61 months. Median OS was 76 months and median RFS was 11 months. Thirteen patients (19%) had CD30+ lymphocytes on initial pathology. In the CD30+ cohort, there were no T2, eight T3, and five T4 cases. In comparison, in the CD30- cohort, there were 18 T2, 29 T3, and 8 T4 cases (P = 0.01). Six weeks post-RTSEI, CCR was 85% in CD30+ and 81% in CD30- cases (P = 1). Six months post-RTSEI, CCR was 23% in CD30+ and 50% in CD30- cases (P = 0.083).
  
  
  CONCLUSIONS
  RTSEI resulted in excellent CCR at 6 weeks in our cohort of patients with CTCL, with a median RFS of 11 months. We found CD30+ patients presented with significantly higher T stage at time of RTSEI and trended towards decreased CCR at 6 months post-RTSEI compared with the CD30- group.
authors.affiliation: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors.forename: Hasan H
authors.initials: HH
authors.lastname: Danish
authors.affiliation: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors.forename: Thatcher R
authors.initials: TR
authors.lastname: Heumann
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Bradley
authors.affiliation: Biostatistics Shared Core Resource, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Switchenko
authors.affiliation: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors.forename: Natia
authors.initials: N
authors.lastname: Esiashvili
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Lechowicz
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Flowers
authors.affiliation: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA. m.k.khan@emory.edu.
authors.forename: Mohammad K
authors.initials: MK
authors.lastname: Khan
keywords: CD30; Complete clinical response; Cutaneous T cell lymphoma; Mycosis fungoides; Overall survival; Relapse-free survival; Rotational total skin electron irradiation