Skin-directed radiation therapy for cutaneous lymphoma: The Mayo Clinic experience - 20/01/20

Doi : 10.1016/j.jaad.2019.07.040

Brian J. King, MD ^a,^b,^⁎ , Scott C. Lester, MD ^c, Stanislav N. Tolkachjov, MD ^b, Mark D.P. Davis, MD ^a, Lawrence E. Gibson, MD ^a, James A. Martenson, MD ^c
^a Department of Dermatology, Mayo Clinic, Rochester, Minnesota
^b Surgical Dermatology Group, Birmingham, Alabama
^c Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota

^∗Reprint requests to: Brian J. King, MD, 1940 Stonegate Dr, Ste 130, Vestavia Hills, AL 35242.1940 Stonegate DrSte 130Vestavia HillsAL35242

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Abstract

Background

Focal or total skin radiation therapy can be used to treat mild to refractory cutaneous T-cell lymphoma.

Objective

To report the broad therapeutic benefit of radiation therapy for cutaneous T-cell lymphoma.

Methods

Retrospective, single-institution review of outcomes for skin-directed radiation therapy.

Results

Skin-directed radiation therapy showed a 99% response rate and 80% complete response rate after treatment regardless of involvement, severity, histopathologic subtype, dose, or fractionation. The overall in-field recurrence rate was 15%, and median time to recurrence was 296 days (range, 1-1884 days). Focal and hypofractionated regimens were similarly associated with disease response and rare toxicity. Short-term rates of secondary skin cancer after treatment were comparable to expected incidence in a patient population without radiation.

Limitations

Large total number of treatments courses compared with overall number of patients. Heterogenous mix of treatment regimens (no standardization of dose or fraction number).