Phototherapy as a first‐line treatment for early‐stage mycosis fungoides: The results of a large retrospective analysis

Nikolaou, Vasiliki; Sachlas, Athanasios; Papadavid, Evangelia; Economidi, Afroditi; Karambidou, Konstantina; Marinos, Leonidas; Stratigos, Alexander J.; Antoniou, Christina

doi:10.1111/phpp.12383

Cited by 23 publications

(34 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After applying the selection criteria, 7 articles were selected for analysis (eFigure 1 in the Supplement). [17][18][19][20][21][22][23] The study and baseline characteristics of these studies are summarized in Table 1 and Table 2. There were a total of 527 patients treated with PUVA compared with 251 treated with NBUVB.…”

Section: Search Resultsmentioning

confidence: 99%

Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides

et al. 2019

View full text Add to dashboard Cite

IMPORTANCE Phototherapy is one of the mainstays of treatment for early mycosis fungoides (MF). The most common modalities are psoralen-UV-A (PUVA) and narrowband UV-B (NBUVB). OBJECTIVE To compare the efficacy and adverse effects of PUVA vs NBUVB in early-stage MF. DATA SOURCES A systematic review was performed by searching Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Ovid Medline, PubMed, Cochrane Library, American College of Physicians ACP Journal Club, and Database of Abstracts of Review of Effectiveness from inception to March 30, 2018. UV A, PUVA, mycosis fungoides, Sézary syndrome, cutaneous T-cell lymphoma, UV B, and UVB were used as either key words or MeSH terms. STUDY SELECTION Studies of cohorts with histologically confirmed early-stage MF, defined as stages IA, IB, and IIA, that compared PUVA vs NBUVB, had at least 10 patients in each comparator group, and reported outcomes of response to therapy. Exclusion criteria were studies with patients with stage IIB or higher MF, pediatric patients, fewer than 10 in each comparator group, noncomparative studies, case reports, and abstract studies. DATA EXTRACTION AND SYNTHESIS The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. Data were pooled using a random-effects model with odds ratio (OR) as effect size. MAIN OUTCOMES AND MEASURES Main outcomes were complete response rate, partial response rate, disease recurrence, and adverse effects, including erythema, nausea, pruritus, phototoxic effects, dyspepsia, and pain. RESULTS Seven studies were included with a total of 778 patients (405 of 724 [55.9%] men; mean age, 52 years); 527 were treated with PUVA and 251 with NBUVB. Most of the included studies were of poor to moderate quality. Any response was found in 479 of the 527 (90.9%) patients treated with PUVA vs 220 of 251 (87.6%) treated with NBUVB (OR, 1.40; 95% CI, 0.84-2.34; P = .20). Complete response was found in 389 of 527 (73.8%) patients who received PUVA vs 156 of 251 (62.2%) who received NBUVB, which was statistically significant (OR, 1.68; 95% CI, 1.02-2.76; P = .04). Partial response was similar (90 of 501 [18.0%] vs 64 of 233 [27.5%]; OR, 0.58; 95% CI, 0.33-1.04; P = .07). No significant difference was found between PUVA and NBUVB in terms of adverse effects of erythema (38 of 527 [7.2%] vs 17 of 251 [6.7%]; P = .54), nausea (10 of 527 [1.9%] vs 3 of 251 [1.2%]; P = .72), pruritus (2 of 527 [0.4%] vs 4 of 251 [1.7%]; P = .26), phototoxic effects (7 of 527 [1.4%] vs 2 of 251 [0.9%]; P = .72), dyspepsia (6 of 527 [1.2%] vs 0 of 251 [0%]; P = .59), or pain (0 of 527 [0%] vs 2 of 251 [0.9%]; P = .50). CONCLUSIONS AND RELEVANCE The findings suggest that PUVA is a potential alternative to NBUVB in the management of early-stage MF. These findings have implications for clinicians involved in the management of early-stage MF.

show abstract

Section: Search Resultsmentioning

confidence: 99%

Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Pavlosky et al found that patients with skin phototypes I-III reached higher complete remission rates and required a lower dose to achieve complete remission compared to patients with dark phototype (13). In the largest series to date of MF patients treated with phototherapy, only 6 patients with dark phototype received NB-UVB (8). In our study, nineteen patients received NB-UVB therapy.…”

Section: Discussionmentioning

confidence: 75%

“…Questions regarding the efficacy of maintenance phase are still debated (4). Studies comparing recurrence rates in patients who received maintenance phase and those who underwent follow-up are scarce including a relatively small proportion of patients with dark phototype (phototypes IV-VI) (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Maintenance phototherapy for the treatment of early stage mycosis fungoides

Gara¹,

Litaiem²,

Bacha³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background : Phototherapy has been a mainstay of treatment of early stages (Ia-IIa) of mycosis fungoides (MF). Despite this, there is no internationally standardized phototherapy regimen schedule for MF. Efficacy of maintenance therapy is poorly evaluated especially in patients with dark phototype (IV-VI). Methods : Thirty patients with early stage MF treated with PUVA therapy and narrowband UVB therapy from January 2004 to January 2016 at a single institution were retrospectively reviewed. Recurrence rate and recurrence-free survival were assessed in patients who received maintenance phase and in those who underwent follow-up. Results : Seventeen patients had patch stage disease while 16 patients had plaque stage disease. Most of the patients (22, 73%) had dark phototype. Nineteen patients received NB-UVB therapy, while 11 patients received PUVA. Mean follow-up period was 36,1 + 13 months. There was no significant association between the recurrence rate and recurrence free survival in patients who received maintenance phase and those who underwent follow-up. Conclusions: Phototherapy is a safe and effective treatment option for patients with early stage MF. Evidence supporting the use of maintenance phase for the treatment of early stages MF is lacking.

show abstract

“…Не было найдено значительных [49]. Согласно опубликованным результатам ретроспективного исследования V. Nikolaou и соавт., в которое вошли данные 227 пациентов с грибовидном микозом на ранних стадиях, уровень достижения полной ремиссии у больных, получающих ПУВА-терапию, был выше на 25 % по сравнению с таковым у больных после УФВ-311 нм (74,5 % против 55,9 % соответственно) [50]. В январе 2019 г. в журнале JAMA Dermatology были опубликованы результаты крупного ретроспективного исследования сравнительной эффективности УФВ-311 нм и ПУВА-терапии у больных грибовидным микозом на стадиях IA-IIA [51].…”

Section: Introductionunclassified

“…Авторы выполнили метаанализ данных 778 больных из 7 ранее проведенных ретроспективных исследований, при выборе пациентов учитывалась стадия заболевания (IA-IIA), а также в целях объективизации результатов отбирались пациенты со схожими режимами назначения УФВ-311 нм и ПУВА-терапии (табл. 5) [47][48][49][50][52][53][54].…”

Section: Introductionunclassified

Phototherapy of mycosis fungoides

Кубанов¹,

Карамова²,

Знаменская³

et al. 2019

Onkogematologiâ

View full text Add to dashboard Cite

В настоящее время фототерапия нашла широкое применение в лечении различных заболеваний кожи, в том числе грибовидного микоза. В статье приводится обзор литературы, посвященный применению различных спектров ультрафиолетовой терапии в лечении больных грибовидным микозом на ранних стадиях развития заболевания. Описаны механизмы действия средневолновой ультрафиолетовой терапии (УФВ-311 нм) и ПУВА-терапии, обусловливающие иммуносупрессивный, противовоспалительный и антипролиферативный эффект. Представлены результаты ретроспективных исследований эффективности применения ПУВА-терапии и УФВ-311 нм у больных Т-клеточной лимфомой кожи, данные современной литературы, свидетельствующие о необходимости стандартизации методов фототерапии больных грибовидным микозом.

show abstract

Phototherapy as a first‐line treatment for early‐stage mycosis fungoides: The results of a large retrospective analysis

Abstract: Our analysis indicates that PUVA leads to better responses and longer relapse-free intervals both in patch- and plaque-stage disease. UVB-NB could be a valid therapeutic alternative for patients with recent disease presentation.

Cited by 23 publications

References 28 publications

Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides

Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides

Maintenance phototherapy for the treatment of early stage mycosis fungoides

Phototherapy of mycosis fungoides

Contact Info

Product

Resources

About