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

Abstract

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.

Advances in the treatment of mycoses fungoides and Sézary syndrome: a narrative update in skin-directed therapies and immune-based treatments

“…Conventional total skin electron beam therapy (TSEBT) has known efficacy in treating MF/SS, though due to the chronic nature of MF/SS, many patients relapse and might face limited options for re-radiation retreatment due to skin toxicity. Therefore, low-dose TSEBT with 10-12 Gy has largely replaced traditional TSEBT (30)(31)(32)(33)(34)(35)(36) in the treatment of MF/SS (13,38). Low-dose TSEBT provides rapid and reliable reduction of disease burden in MF/SS patients, and it can be safely administered in multiple instances with an acceptable toxicity profile (13).…”