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Evaluation of mycosis fungoides management by total skin electron beam therapy with "translational technique".

PURPOSE
The aim of this study was to evaluate the outcomes of total skin electron beam therapy (TSEBT) with "translational technique" in the management of mycosis fungoides (MF).


METHODS
Between January 1995 and October 2014, 51 patients with MF were treated using TSEBT with translational technique. The total dose was 2800-3600 cGy, de-livered in 7 to 20 fractions. Out of the total 51 patients, 22 (43.1%) had T2 (generalized patch/plaque) disease, 20 (39.3%) had T3 disease (tumor stage), and 9 (17.6%) had T4 (erythrodermic) disease. Radiation-related late skin injury parameters including atrophy, pigmentation changes, hair loss, telangiectasia and ulceration were assessed according to RTOG/EORTC Late Radiation Morbidity Scoring Schema after at least 3 months from TSEBT.


RESULTS
Treatment response was categorized as complete remission (CR), partial remission (PR), or non-responding (NR) lesions. After TSEBT with translational technique, CR rate was 68.6% and PR rate 23.5%, while the NR rate was 7.9%. Overall, the rates of grade 1, grade 2, grade 3, and grade 4 toxicity were 17.6% )9 patients), 39.3% (20 patient), 35.3% (18 patients), and 7.8% (4 patients), respectively. At a median follow-up of 79 months (range 14-142), overall survival (OS) and disease-free survival (DFS) rates were 83% and 46%, respectively.


CONCLUSION
For patients with MF refractory to topical chemotherapy and phototherapy, TSEBT with translational technique offers excellent local control (LC: CR+PR) and favorable OS rates along with substantial relief of symptoms.