How effective is the treatment of localized mycosis fungoides cutaneous T-cell lymphoma (CTCL)?

Updated: Aug 15, 2018
  • Author: Lauren C Pinter-Brown, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

A retrospective review by Thomas et al indicated that the use of a single dose of radiation (700-800 cGy) in place of multiple-fraction radiation treatment still results in excellent palliation in patients with cutaneous T-cell lymphoma. The investigators reviewed the results of radiation treatment in 270 lesions in a total of 58 patients (most of whom had mycosis fungoides); 97% of the lesions had been treated with 700 cGy or more of radiation. [97]

Over a mean follow-up period of 41.3 months, Thomas et al noted a complete response occurred in 255 (94.4%) lesions and a partial response rate occurred in 10 (3.7%) lesions. Four lesions (1.5%) demonstrated a partial response that, following a second treatment, became a complete response. Only one lesion (0.4%) showed no response. [97]

The investigators also found the following results:

  • A lower complete-response rate in the lower extremities than in other parts of the body

  • A lower complete-response rate in lesions treated with photons than in those treated with electrons

  • A lower complete-response rate in patients whose lesions demonstrated large-cell transformation and tumor morphology

  • A significantly lower overall survival rate in patients with Sézary syndrome and erythroderma than in other patients

Thomas et al also determined that the cost of multiple-fraction radiation treatment was more than 200% greater than it was for single-fraction therapy.

See also the clinical guideline summary, Guidelines for topical photodynamic therapy: update, from the British Association of Dermatologists.


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