The results of Low dose Total Skin Electron Beam Radiotherapy (TSEB), in patients with mycosis fungoides from the UK cutaneous lymphoma group
Menée auprès de 103 patients atteints d'un mycosis fongoïde de stade IB à IV (âge médian : 68 ans ; durée médiane de suivi : 20,6 mois), cette étude évalue l'efficacité, du point de vue du taux de réponse complète, et la toxicité de faibles doses de rayonnements ionisants ciblant l'ensemble de la peau et délivrés à l'aide d'une radiothérapie par faisceaux d'électrons
Introduction : TSEB is a very effective treatment for mycosis fungoides. Following reports of similar durations of response to lower doses of TSEB a low dose schedule of TSEB was introduced in the UK. Methods : A 2-week protocol of 12Gy in 8 fractions over 2 weeks was agreed, using the Stanford technique. Data was collected prospectively and the results analysed according to the EORTC/ISCL endpoints. Toxicity was scored according to the CTCAEv4.0. Results : 103 patients received treatment with a median follow up of 20.6 months (range 3.3 to 53 months). 54 patients were stage IB, 33 stage IIB, 12 stage III and 4 stage IV. The median age was 68 (range 26 – 91). The complete response rate was 18%, partial response rate 69%, stable disease 8% and 5% progressed on treatment. In the patients who had a complete response the median time to relapse was 7.3 months. The median response duration was 11.8 months. The median PFS for all patients was 13.2 months. It was significantly longer at 26.5 months in Stage IB patients compared to 11.3 months in Stage IIB patients (p=0.003, HR 2.66) and 10.2 months in stage III patients (p=0.002, HR 4.62). The treatment was well tolerated with lower toxicity than higher dose schedules. Conclusions : The low dose 12Gy in 8-fraction schedule of TSEB over 2 weeks is well tolerated and is an effective option for patients with mycosis fungoides.