Radiotherapy of primary cutaneous anaplastic large cell lymphoma: our experience in 30 cases

Abstract

Background Since the observation of new cases of primary cutaneous anaplastic large cell lymphoma (PCALCL) with a seemingly aggressive clinical presentation and a favorable response to radiation therapy (RT), a review of our series has been performed to evaluate the results of RT. Materials and methods The study is a retrospective analysis of 30 patients with PCALCL treated with conventional energy RT. Results About 55 fields of irradiation were performed. Complete clinical response (CCR) was obtained in 29 cases and a partial clinical response (PCR) in one. Two lesions had a marginal relapse at 7 and 37 months, respectively. In eight cases, new lesions appeared in the same body district and in six cases, in body sites at distance from the field of treatment. Total radiation dose ranged from 15 to 35 Gy (median 25 Gy). Follow‐up range was 2–218 months (median 38.5 months) with a local control rate of 85% and a relapse‐free rate of 49% at 5 years from RT. Three cases developed a nodal involvement. Conclusions PCALCL belongs to the group of primary cutaneous CD30+ lymphoproliferative disorders, accounting for 25–30% of cutaneous T‐cell lymphomas. RT is considered of choice as alternative to surgical excision of solitary lesions. Recent studies have focused on ideal dose to obtain local control indicating 30 Gy as adequate, but others have hypothesized that lower doses may suffice. Our study confirms the excellent role of RT in the local control of the disease with total doses ≤25 Gy.

Master of mimicry: Rare primary cutaneous anaplastic large cell lymphoma presenting as fungating parotid tumor–case report and review

“…This appearance of advanced stage disease might prompt a surgeon to hastily perform a superficial parotidectomy to curb further locoregional spread. When in fact, PC-ALCL responds well to chemo- and radiotherapy [1] , [2] , [3] , [9] , [15] which spares the patient from a parotidectomy that carries the debilitating morbidity of facial nerve injury. Primary lymphomas of the parotid gland are another differential diagnosis.…”

“…PC-ALCL carries good prognosis [1] , [2] , [7] , [8] . PC-ALCL undergoes episodes of relapsing lesions and 25% spontaneously resolve [2] , [7] , [8] , [9] . Solitary PC-ALCL that do not regress, respond well to radiotherapy [3] , [9] and can be combined with surgical excision.…”

“…PC-ALCL undergoes episodes of relapsing lesions and 25% spontaneously resolve [2] , [7] , [8] , [9] . Solitary PC-ALCL that do not regress, respond well to radiotherapy [3] , [9] and can be combined with surgical excision. Complete remission (CR) rates range from 67% to 95% [3] , [7] , [9] .…”

“…Solitary PC-ALCL that do not regress, respond well to radiotherapy [3] , [9] and can be combined with surgical excision. Complete remission (CR) rates range from 67% to 95% [3] , [7] , [9] . Unfortunately, data on appropriate surgical margins are lacking [3] .…”

“…Good prognosis is reported, with 5- and 10-year survival rates more than 90% [1] , [2] , [3] , [7] , [8] . In extracutaneous PC-ALCL, systemic chemotherapy is first line therapy [2] , [3] , [7] , [9] . Recently, task forces have sought to establish diagnostic criteria and management guidelines for these lymphoproliferative disorders [3] .…”