A prospective cohort study of condensed low-dose total skin electron beam therapy for mycosis fungoides: Reduction of disease burden and improvement in quality of life

Song, Andrew; Gochoco, Ashley; Sahu, Joya; Alpdoğan, Önder; Porcu, Pierluigi; Nikbakht, Neda; Shi, Wenyin

doi:10.1016/j.jaad.2020.01.046

Cited by 15 publications

(9 citation statements)

References 14 publications

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“…Total skin electron beam (TSEB) irradiation at a standard dose of 30–36 Gy over a period of 8–10 weeks gave complete remission (CR) rates of 47 % in T2 and 75 % in T3, and also a decreased peripheral tumor cell burden in SS [ 88 ]. Recent data on the efficacy of low‐dose TSEB with 12 Gy showed a total response rate of 88 % with 24 % CR, no toxicity above grade III, and a significant improvement of HRQoL with decreased disease burden [ 89 ].…”

Section: Skin‐directed Therapiesmentioning

confidence: 99%

Mycosis fungoides and Sézary syndrome

Jonak

Tittes

Brunner

et al. 2021

J Deutsche Derma Gesell

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Mycosis fungoides (MF) and Sézary syndrome (SS) are primary cutaneous T-cell lymphomas (CTCL) with not yet fully understood etiology and pathogenesis. Conceptually, MF and SS are classified as distinct entities arising from different T helper cell subsets. MF is the most common CTCL entity, while SS is very rare. MF presents clinically with patch, plaque and/or tumor stages, but can also evolve as erythroderma, which in turn is pathognomonic for SS. SS is characterized by a detectable tumor-cell burden (Sézary cells) in the peripheral blood consistent with advanced-stage disease and a poor prognosis. In early-stage disease of MF, which is the predominant form, the prognosis is generally favorable. However, in up to 30 % of patients, there is progression of skin lesions, which can ultimately lead to visceral involvement. The histological manifestation of MF can be subtle in early-stage disease and therefore a careful clinicopathological correlation is paramount. The treatment of MF/SS is dependent on the disease stage. Therapeutic options include both skin-directed and systemic regimens. Apart from allogeneic stem cell transplantation (alloSCT), there is as yet no curative therapy for MF/SS. Accordingly, the treatment approach is symptom oriented and aims to reduce the tumor burden and improve health-related quality of life. However, the therapeutic landscape for CTCL is constantly being expanded by the discovery of novel therapeutic targets.

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Section: Skin‐directed Therapiesmentioning

confidence: 99%

Mycosis fungoides and Sézary syndrome

Jonak

Tittes

Brunner

et al. 2021

J Deutsche Derma Gesell

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“…The study by Goujon et al 14 did fulfill the MF/SS standardized staging system and evaluation of outcomes despite being published before the official publication of the consensus paper, 3 and therefore we included it in the analysis. The characteristics of the studies included in the final analysis are summarized in Table 1 alongside patients demographic details 15–26 …”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the studies included in the final analysis are summarized in Table 1 alongside patients demographic details. [15][16][17][18][19][20][21][22][23][24][25][26] These studies included 616 patients, of which 67% were males.…”

Section: Resultsmentioning

confidence: 99%

Short‐term efficacy and safety of total skin electron beam therapy in mycosis fungoides: Systematic review and meta‐analysis

Grandi

Simontacchi

Pileri

et al. 2022

Dermatologic Therapy

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Total skin electron beam therapy (TSEBT) is one of the mainstays of treatment for mycosis fungoides. The most common modalities are standard dose (30-36 Gy) and low dose (10-12 Gy). To review the literature on the efficacy and safety profiles of standard dose and low dose TSEBT. We searched electronic databases for studies that enrolled patients with Mycosis Fungoides and treated with TSEBT. We estimated the event rates associated with low dose and standard dose TSEBT. The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Main outcomes were complete response rate, partial response rate, mild and severe adverse events rate low dose TSEBT had a Complete Response Rate of 28% [0.19, 0.37], an Overall Response Rate of 85% [0.76, 0.93], a mild adverse events rate of 93% [0.82, 1.04] and a severe adverse events rate of 5% [À0.04; 0.14] Standard dose TSEBT had a Complete Response Rate of 57% [0.41; 0.73], the Overall Response Rate was 99% [0.97; 1.02], the mild adverse events rate was 100%, the severe adverse events rate was 7% [À0.01; 0.16]. Comparing standard dose TSEBT in the early versus advanced stages, advanced stages patients had a Risk Ratio = 0.77 in obtaining a Complete Response [0.64, 0.92](p = 0.0158). TSEBT is an associated with an excellent short term safety profile. Both schedules show high ORR, with standard dose TSEBT demonstrating highest CRR. Advanced stage of disease negatively influence the CRR.

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“…Kroeger et al achieved adequate treatment results with fewer grade 2 skin toxicities with low-dose (12 Gy) TSEI compared to conventional doses [16]. Additionally, the low total dose is important in terms of the need for a second treatment and improved quality of life [17,18]. Today, for TSEI, a total dose of 12-36 Gy is often preferred as 4-6 Gy per week, and complete response rates are 90% and above some series [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Ultra-Low-Dose Radiotherapy for Palliation of Mycosis Fungoides

Aral¹,

Gürok

Konuk

et al. 2020

Case Reports in Dermatological Medicine

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Introduction. Mycosis fungoides (MF) is a form of primary cutaneous T-cell lymphomas, and radiotherapy (RT) has been used to treat localized/limited lesions of MF. In this case report, the results of low-dose RT applied for palliative purpose are shared. Case Report. A 70-year-old male patient was admitted to the outpatient clinic 7 months ago with a generalized itchy rash. The result of the biopsy was reported as mycosis fungoides. Systemic treatment was not performed due to comorbid diseases. The hemibody RT was applied. 2 Gy was given per fraction, with a total dose of 6 Gy. The significant clinical relief was observed with 6 Gy RT. The patient died due to multiorgan failure 2 months later, and no recurrence was observed. Conclusion. The palliation was achieved in the advanced MF patient with fractionated 6 Gy hemibody RT for the remaining 2 months of life.

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A prospective cohort study of condensed low-dose total skin electron beam therapy for mycosis fungoides: Reduction of disease burden and improvement in quality of life

Cited by 15 publications

References 14 publications

Mycosis fungoides and Sézary syndrome

Mycosis fungoides and Sézary syndrome

Short‐term efficacy and safety of total skin electron beam therapy in mycosis fungoides: Systematic review and meta‐analysis

Ultra-Low-Dose Radiotherapy for Palliation of Mycosis Fungoides

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