Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California.
Department of Dermatology, Stanford Cancer Institute, Stanford, California.
J Am Acad Dermatol. 2015 Feb;72(2):286-92. doi: 10.1016/j.jaad.2014.10.014. Epub 2014 Dec 2.
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.
We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT.
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.
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.
Conclusions are limited because of the small number of patients.
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.
标准剂量（36 戈瑞）全身电子束治疗（TSEBT）是蕈样肉芽肿的一种非常有效的治疗方法。然而，该方案时间密集，可能与显著的毒性有关。
我们旨在评估低剂量（12 戈瑞）TSEBT 相关的疗效和耐受性。
汇总了 3 项使用低剂量（12 戈瑞）TSEBT 的临床试验数据。在所有试验中，TSEBT 初治的 I 期至 IIIA 期蕈样肉芽肿患者接受 TSEBT（12 Gy，3 周内 1 Gy/次）治疗。主要终点是临床缓解率。次要终点包括缓解时间和临床获益持续时间。
共纳入 33 例患者。其中 18 例为男性，分期为 22 例 IB、2 例 IIA、7 例 IIB 和 2 例 IIIA。总缓解率为 88%（29/33），其中 9 例患者达到完全缓解。缓解时间的中位数为 7.6 周（3-12.4 周）。临床获益持续时间的中位数为 70.7 周（95%置信区间 41.8-133.8 周）。TSEBT 的毒性为轻度和可逆的。
由于患者数量较少，结论受到限制。
低剂量 TSEBT 可可靠且快速地减轻蕈样肉芽肿患者的疾病负担，并且可以在患者疾病过程中多次安全地给予，具有可接受的毒性特征。
