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Journal of the American Academy of Dermatology
Volume 72, n° 2
pages 286-292 (février 2015)
Doi : 10.1016/j.jaad.2014.10.014
accepted : 13 October 2014
Original Articles

Low-dose total skin electron beam therapy as an effective modality to reduce disease burden in patients with mycosis fungoides: Results of a pooled analysis from 3 phase-II clinical trials
 

Richard T. Hoppe, MD a, , Cameron Harrison, MD b, Mahkam Tavallaee, MD, MPH b, Sameer Bashey, MD b, Uma Sundram, MD, PhD b, c, Shufeng Li, MS b, Lynn Million, MD a, Bouthaina Dabaja, MD d, Pamela Gangar, MD e, Madeleine Duvic, MD e, Youn H. Kim, MD b
a Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California 
b Department of Dermatology, Stanford Cancer Institute, Stanford, California 
c Department of Pathology, Stanford Cancer Institute, Stanford, California 
d Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas 
e Department of Dermatology, MD Anderson Cancer Center, Houston, Texas 

Reprint requests: Richard T. Hoppe, MD, Stanford University School of Medicine, 875 Blake Wilbur Dr, Clinic D, Stanford, CA 94305.
Abstract
Background

Standard-dose (36-Gy) total skin electron beam therapy (TSEBT) is a highly effective treatment in mycosis fungoides. However, the regimen is time-intensive and may be associated with significant toxicity.

Objective

We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT.

Methods

Data from 3 clinical trials using low-dose (12-Gy) TSEBT were pooled. In all trials, TSEBT-naïve patients with stage IB to IIIA mycosis fungoides were treated with TSEBT (12 Gy, 1 Gy per fraction over 3 weeks). The primary end point was clinical response rate. Secondary end points included time to response and duration of clinical benefit.

Results

In all, 33 patients enrolled. Eighteen were male; stages were 22 IB, 2 IIA, 7 IIB, and 2 IIIA. Overall response rate was 88% (29/33), including 9 patients with complete response. Median time to response was 7.6 weeks (3-12.4 weeks). Median duration of clinical benefit was 70.7 weeks (95% confidence interval 41.8-133.8 weeks). Toxicities from TSEBT were mild and reversible.

Limitations

Conclusions are limited because of the small number of patients.

Conclusions

Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with mycosis fungoides, which could be administered safely multiple times during the course of a patient's disease with acceptable toxicity profile.

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

Key words : cutaneous lymphoma, low-dose total skin electron beam therapy, radiotherapy, T-cell lymphoma, total skin electron beam therapy

Abbreviations used : AE, CR, DOCB, DOR, MF, mSWAT, ORR, PD, PR, TSEBT, TTP, TTR



 This study was partially supported by the Haas Family Foundation and Merck.
 Conflicts of interest: None declared.



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