Low-dose total skin electron beam therapy as an effective modality to reduce disease burden in patients with mycosis fungoides: Results of a pooled analysis from 3 phase-II clinical trials

Published:December 01, 2014DOI:https://doi.org/10.1016/j.jaad.2014.10.014

      Background

      Standard-dose (36-Gy) total skin electron beam therapy (TSEBT) is a highly effective treatment in mycosis fungoides. However, the regimen is time-intensive and may be associated with significant toxicity.

      Objective

      We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT.

      Methods

      Data from 3 clinical trials using low-dose (12-Gy) TSEBT were pooled. In all trials, TSEBT-naïve patients with stage IB to IIIA mycosis fungoides were treated with TSEBT (12 Gy, 1 Gy per fraction over 3 weeks). The primary end point was clinical response rate. Secondary end points included time to response and duration of clinical benefit.

      Results

      In all, 33 patients enrolled. Eighteen were male; stages were 22 IB, 2 IIA, 7 IIB, and 2 IIIA. Overall response rate was 88% (29/33), including 9 patients with complete response. Median time to response was 7.6 weeks (3-12.4 weeks). Median duration of clinical benefit was 70.7 weeks (95% confidence interval 41.8-133.8 weeks). Toxicities from TSEBT were mild and reversible.

      Limitations

      Conclusions are limited because of the small number of patients.

      Conclusions

      Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with mycosis fungoides, which could be administered safely multiple times during the course of a patient's disease with acceptable toxicity profile.

      Key words

      Abbreviations used:

      AE ( adverse event), CR ( complete response), DOCB ( duration of clinical benefit), DOR ( duration of response), MF ( mycosis fungoides), mSWAT ( modified severity weighted assessment tool), ORR ( overall response rate), PD ( progressive disease), PR ( partial response), TSEBT ( total skin electron beam therapy), TTP ( time to progression), TTR ( time to response)
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