Total Skin Electron Beam Therapy in the Treatment of Mycosis Fungoides: a review of Conventional and Low-Dose Regimens

Publication date: Available online 29 August 2016 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Mudit Chowdhary, Arpit M. Chhabra, Shivam Kharod, Gaurav Marwaha Mycosis fungoides (MF) is the most prevalent subtype of cutaneous T-cell lymphoma, which is characterized by the proliferation of CD4+ T-cells. While often an indolent disease, most patients eventually develop progression from isolated patches to tumors and finally nodal or visceral involvement. Treatment choice is largely based on disease burden, though prognostic factors such as disease stage, patient age, and extra-cutaneous involvement must be taken into consideration. Radiation therapy represents one of the most effective therapeutic modalities in the treatment of MF. Lymphocytes are exquisitely radiosensitive and excellent responses are seen even with low doses of radiation. Total skin electron beam therapy (TSEBT) is a special technique that allows for the homogenous irradiation of the entire skin. There are well-documented radiation dose-response relationships for achieving a complete response. As such, TSEBT doses ≥30 Gy comprise the current standard of care. Although highly effective, most patients experience recurrent disease even after conventional-dose (≥30 Gy) TSEBT. In addition, toxicity is cumulative dose-dependent and there is reluctance to administer multiple courses of conventional-dose TSEBT. Consequently, there has been renewed interest in determining the utility of TSEBT at l...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research