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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 11 juillet 2013
Doi : 10.1016/j.jaad.2013.04.063
accepted : 16 April 2013
Acute toxicity and risk of infection during total skin electron beam therapy for mycosis fungoides
 

Shane Lloyd, MD a, Zhe Chen, PhD a, Francine M. Foss, MD b, Michael Girardi, MD, FAAD c, Lynn D. Wilson, MD, MPH, FASTRO a,
a Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut 
b Department of Medicine (Hematology), Yale School of Medicine, New Haven, Connecticut 
c Department of Dermatology, Yale School of Medicine, New Haven, Connecticut 

Reprint requests: Lynn D. Wilson, MD, MPH, FASTRO, Yale School of Medicine, 33 Cedar St, PO Box 208040, New Haven, CT 06520-8040.
Abstract
Background

Detailed rates of acute toxicity and skin infection during total skin electron beam therapy (TSEBT) for mycosis fungoides have not been reported in a large, modern series.

Objective

We sought to demonstrate the rates of acute toxicity and skin infection during TSEBT.

Methods

We retrospectively reviewed 89 consecutive courses of TSEBT. In all, 82 courses were prescribed a dose of 30 to 36 Gy and were included in the toxicity analysis. We recorded the types and grades of acute treatment toxicities and the incidence of infection during TSEBT for comparison with the previously documented baseline incidence of infection in mycosis fungoides.

Results

The most common toxicities included erythema/desquamation (76%), blisters (52%), hyperpigmentation (50%), and skin pain (48%). The worst reported toxicity grade per patient was grade 1 in 21%, grade 2 in 67%, and grade 3 in 10%, with no grade 4 or 5 toxicities. According to the previously reported rate, a total of 2.4 infections were expected for our cohort at baseline. The number with skin infection was 26 (32%) (relative risk 10.8, P < .01), and of these, 12 (15%) were culture confirmed (relative risk 5.0, P < .01).

Limitations

This was a retrospective study design.

Conclusion

The risk of cutaneous infection is significant during TSEBT.

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

Key words : extracorporeal photopheresis, infection, mycosis fungoides, race, radiation therapy, toxicity

Abbreviations used : AJCC, ECP, MF, OR, RT, TSEBT



 Funding sources: None.
 Disclosure: Dr Wilson receives research support from Merck. Drs Lloyd, Chen, Foss, and Girardi have no financial conflicts of interest to declare.



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