Department of Dermatology, Stanford Cancer Center, Stanford, California 94063, USA.
Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):e651-7. doi: 10.1016/j.ijrobp.2011.01.023. Epub 2011 Apr 12.
Total skin electron beam therapy (TSEBT) is a highly effective treatment for mycosis fungoides (MF). The standard course consists of 30 to 36 Gy delivered over an 8- to 10-week period. This regimen is time intensive and associated with significant treatment-related toxicities including erythema, desquamation, anhydrosis, alopecia, and xerosis. The aim of this study was to identify a lower dose alternative while retaining a favorable efficacy profile.
One hundred two MF patients were identified who had been treated with an initial course of low-dose TSEBT (5-<30 Gy) between 1958 and 1995. Patients had a T stage classification of T2 (generalized patch/plaque, n = 51), T3 (tumor, n = 29), and T4 (erythrodermic, n = 22). Those with extracutaneous disease were excluded.
Overall response (OR) rates (>50% improvement) were 90% among patients with T2 to T4 disease receiving 5 to <10 Gy (n = 19). In comparison, OR rates between the 10 to <20 Gy and 20 to <30 Gy subgroups were 98% and 97%, respectively. There was no significant difference in median progression free survival (PFS) in T2 and T3 patients when stratified by dose group, and PFS in each was comparable to that of the standard dose.
OR rates associated with low-dose TSEBT in the ranges of 10 to <20 Gy and 20 to <30 Gy are comparable to that of the standard dose (≥ 30 Gy). Efficacy measures including OS, PFS, and RFS are also favorable. Given that the efficacy profile is similar between 10 and <20 Gy and 20 and <30 Gy, the utility of TSEBT within the lower dose range of 10 to <20 Gy merits further investigation, especially in the context of combined modality treatment.
全身电子束治疗（TSEBT）是蕈样肉芽肿（MF）的一种非常有效的治疗方法。标准疗程包括 30 至 36 Gy，在 8 至 10 周内完成。这种方案时间密集，与显著的治疗相关毒性相关，包括红斑、脱屑、无汗、脱发和干燥。本研究的目的是在保留良好疗效的同时，确定一种较低的剂量替代方案。
1958 年至 1995 年间，共有 102 例 MF 患者接受了初始低剂量 TSEBT（5-<30 Gy）治疗。患者的 T 期分类为 T2（广泛斑块/斑块，n = 51）、T3（肿瘤，n = 29）和 T4（红皮病，n = 22）。排除有皮肤外疾病的患者。
接受 5 至<10 Gy 治疗的 T2 至 T4 疾病患者的总缓解（OR）率（>50%改善）为 90%（n = 19）。相比之下，10 至<20 Gy 和 20 至<30 Gy 亚组的 OR 率分别为 98%和 97%。按剂量分组分层时，T2 和 T3 患者的中位无进展生存期（PFS）无显著差异，且每个亚组的 PFS 与标准剂量相当。
10 至<20 Gy 和 20 至<30 Gy 范围内的低剂量 TSEBT 的 OR 率与标准剂量（≥30 Gy）相当。包括 OS、PFS 和 RFS 在内的疗效指标也很有利。鉴于 10 至<20 Gy 和 20 至<30 Gy 之间的疗效相似，低剂量范围（10 至<20 Gy）内的 TSEBT 实用性值得进一步研究，特别是在联合治疗的背景下。
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