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Journal of the American Academy of Dermatology
Volume 80, n° 6
pages 1550-1555 (juin 2019)
Doi : 10.1016/j.jaad.2018.05.023
accepted : 5 May 2018
Original Articles

Potential of narrow-band ultraviolet B to induce sustained durable complete remission off-therapy in patients with stage I mycosis fungoides
 

Felix Pavlotsky, MD a, b, , Marwan Dawood, BA b, Aviv Barzilai, MD a, b
a Phototherapy Unit, Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel 
b Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 

Correspondence to: Felix Pavlotsky, MD, Phototherapy Unit, Department of Dermatology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.Phototherapy UnitDepartment of DermatologySheba Medical CenterTel Hashomer, Ramat Gan52621Israel
Abstract
Background

Narrow-band ultraviolet B (NB-UVB) is a first-line therapy for stage I mycosis fungoides (MF), with a complete response in 75%-85% of patients. However, data on long-term disease-free survival (DFS) after therapy are scarce.

Objective

To assess the long-term DFS after NB-UVB treatment of stage I MF.

Methods

We used a historic cohort of all stage I MF patients achieving a complete response with NB-UVB who discontinued treatment before 2011. Age at the beginning of phototherapy, sex, stage, skin phototype, number of treatments, total dose, and the length of DFS was collected.

Results

Of the 117 patients who started NB-UVB, 93 patients (80%) had a complete response and 56 (60%) were disease free as of March 2017. In a multivariate analysis, DFS was affected independently by age and disease stage only. DFS was longer for patients <50 years old (124 months) than those ≥50 years old (91 months, P  = .01) and longer for stage IA patients (131 months) than stage IB patients (87.6 months, P  = .001).

Limitations

The study was retrospective in nature.

Conclusion

After a single course of NB-UVB, over a half of stage I MF patients achieved >5 years of DFS and were potentially cured. Thus, NB-UVB can be considered a disease-modifying therapy.

The full text of this article is available in PDF format.

Key words : complete response, disease-free survival, mycosis fungoides, narrow-band UVB

Abbreviations used : CR, DFS, MF, NB-UVB, PUVA



 Funding sources: None.
 Conflicts of interest: None disclosed.
 Reprints not available from the authors.



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