Low-Dose Total Skin Electron Beam Therapy as a Debulking Agent for Cutaneous T-Cell Lymphoma: An open-label prospective phase II study

TY - JOUR

T1 - Low-Dose Total Skin Electron Beam Therapy as a Debulking Agent for Cutaneous T-Cell Lymphoma: An open-label prospective phase II study

AU - Kamstrup, M R

AU - Lindahl, Lise Maria

AU - Gniadecki, R

AU - Iversen, Lars

AU - Skov, L

AU - Petersen, P M

AU - Loft, Annika

AU - Specht, L

N1 - Copyright © 2011 British Association of Dermatologists.

PY - 2012/1

Y1 - 2012/1

N2 - Summary Background Total skin electron beam therapy (TSEBT) is a powerful treatment for cutaneous T-cell lymphoma (CTCL). Based on the occurrence of relapses with low radiation doses, doses of 30-36 Gy are commonly used but most patients still eventually relapse and repeat treatment courses are limited due to the cumulative toxicity. Complete response (CR) rates are about 60-90% for T2-4 stages with a 5-year relapse-free survival of 10-25% for stages IB-III. Objectives To evaluate prospectively the efficacy of low-dose TSEBT (10 Gy) in terms of complete cutaneous response rate, overall response rate and response duration in CTCL. Methods Ten patients with stage IB-IV mycosis fungoides (MF) were treated in an open-label manner with four fractions of TSEBT 1 Gy weekly to a total skin dose of 10 Gy. Treatment responses were assessed at 1 and 3 months after treatment and subsequently at least every 6 months for a total period of 2 years or to disease relapse or progression. Results Patients achieved an overall response rate of 90%. The rate of CR or very good partial response (VGPR; < 1% skin affected with patches/plaques) was 70%. The median response duration was 5·2 months (range 83-469 days) for CR and VGPR. Adverse effects were generally mild to moderate in severity. Conclusions Low-dose TSEBT (10 Gy) gave a satisfactory response rate and was well tolerated in patients with MF stage IB-IV. Future studies should determine if the combination of low-dose TSEBT with other agents could increase the rate of CR and response duration.

AB - Summary Background Total skin electron beam therapy (TSEBT) is a powerful treatment for cutaneous T-cell lymphoma (CTCL). Based on the occurrence of relapses with low radiation doses, doses of 30-36 Gy are commonly used but most patients still eventually relapse and repeat treatment courses are limited due to the cumulative toxicity. Complete response (CR) rates are about 60-90% for T2-4 stages with a 5-year relapse-free survival of 10-25% for stages IB-III. Objectives To evaluate prospectively the efficacy of low-dose TSEBT (10 Gy) in terms of complete cutaneous response rate, overall response rate and response duration in CTCL. Methods Ten patients with stage IB-IV mycosis fungoides (MF) were treated in an open-label manner with four fractions of TSEBT 1 Gy weekly to a total skin dose of 10 Gy. Treatment responses were assessed at 1 and 3 months after treatment and subsequently at least every 6 months for a total period of 2 years or to disease relapse or progression. Results Patients achieved an overall response rate of 90%. The rate of CR or very good partial response (VGPR; < 1% skin affected with patches/plaques) was 70%. The median response duration was 5·2 months (range 83-469 days) for CR and VGPR. Adverse effects were generally mild to moderate in severity. Conclusions Low-dose TSEBT (10 Gy) gave a satisfactory response rate and was well tolerated in patients with MF stage IB-IV. Future studies should determine if the combination of low-dose TSEBT with other agents could increase the rate of CR and response duration.

U2 - 10.1111/j.1365-2133.2011.10670.x

DO - 10.1111/j.1365-2133.2011.10670.x

M3 - Journal article

C2 - 21967035

SN - 0007-0963

VL - 166

SP - 399

EP - 404

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 2

ER -