Department of Radiation Oncology, James Cancer Hospital, The Ohio State University , Columbus, OH , USA.
Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center , Sacramento, CA , USA.
Front Oncol. 2015 Feb 24;5:49. doi: 10.3389/fonc.2015.00049. eCollection 2015.
Cutaneous T-cell lymphoma (CTCL) is known to have an excellent response to radiotherapy, an important treatment modality for this disease. In patients with extremity and digit involvement, the irregular surface and depth variations create difficulty in delivering a homogenous dose using electrons. We sought to evaluate photon irradiation with rice packing as tissue equivalence and determine clinical tolerance and response.
Three consecutive CTCL patients with extensive lower extremity involvement including the digits were treated using external beam photon therapy with rice packing for tissue compensation. The entire foot was treated to 30-40 Gy in 2-3 Gy per fraction using 6 MV photons prescribed to the mid-plane of an indexed box filled with rice in which the foot was placed. Treatment tolerance and response were monitored with clinical evaluation.
All patients tolerated the treatment without treatment breaks. Toxicities included grade 3 erythema and desquamation with resolution within 4 weeks. No late toxicities were observed. All patients had a partial response by 4 weeks after therapy with two patients achieving a complete response. Patients reported improved functionality after treatment. No local recurrence has been observed.
Tissue compensation with rice packing offers a convenient, inexpensive, and reproducible method for the treatment of CTCL with highly irregular surfaces.
皮肤 T 细胞淋巴瘤（CTCL）对放射治疗有很好的反应，放射治疗是该病的重要治疗方式。对于四肢和指部受累的患者，不规则的表面和深度变化使得使用电子束难以提供均匀的剂量。我们试图评估使用米袋作为组织等效物的光子照射，并确定临床耐受和反应。
连续 3 例 CTCL 患者下肢广泛受累，包括手指，采用外部束光子治疗并用米袋进行组织补偿。整个足部接受 30-40Gy 的治疗，每次 3-4Gy，使用 6MV 光子，将剂量规定在填充米的索引盒的中平面，将足部置于其中。通过临床评估监测治疗的耐受性和反应。
所有患者均无治疗中断地耐受了治疗。毒性包括 3 级红斑和脱屑，在 4 周内缓解。未观察到晚期毒性。所有患者在治疗后 4 周内均有部分缓解，2 例患者达到完全缓解。患者在治疗后报告了功能的改善。未观察到局部复发。
米袋组织补偿为治疗具有高度不规则表面的 CTCL 提供了一种方便、经济且可重复的方法。
