Gentile Michelle S, Martinez-Escala Maria Estela, Thomas Tarita O, Guitart Joan, Rosen Steven, Kuzel Timothy, Mittal Bharat B
Department of Radiation Oncology, Northwestern University, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA.
Department of Dermatology, Northwestern University, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA.
Biomed Res Int. 2015;2015:629587. doi: 10.1155/2015/629587. Epub 2015 Oct 4.
CD30(+) lymphoproliferative disorder is a rare variant of cutaneous T-cell lymphoma. Sustained complete response following first-line treatments is rare. This retrospective review evaluates the response of refractory or recurrent lesions to palliative radiation therapy.
The records of 6 patients with 12 lesions, treated with radiation therapy, were reviewed. All patients received previous first-line treatments. Patients with clinical and pathological evidence of symptomatic CD30(+) lymphoproliferative disorder, with no history of other cutaneous T-cell lymphoma variants, and with no prior radiation therapy to the index site were included.
The median age of patients was 50.5 years (range, 15-83 years). Median size of the treated lesions was 2.5 cm (range, 2-7 cm). Four sites were treated with a single fraction of 750-800 cGy (n = 3) and 8 sites were treated with 4000-4500 cGy in 200-250 cGy fractions (n = 3). Radiation therapy was administered with electrons and bolus. Median follow-up was 113 months (range, 16-147 months). For all sites, there was 100% complete response with acute grade 1-2 dermatitis.
For recurrent and symptomatic radiation-naïve CD30(+) lymphoproliferative disorder lesions, palliative radiation therapy shows excellent response. A single fraction of 750-800 cGy is as effective as a multifractionated course and more convenient.
CD30(+)淋巴细胞增殖性疾病是皮肤T细胞淋巴瘤的一种罕见变体。一线治疗后持续完全缓解的情况很少见。本回顾性研究评估姑息性放射治疗对难治性或复发性病变的反应。
回顾了6例患者12个病变接受放射治疗的记录。所有患者均接受过先前的一线治疗。纳入具有症状性CD30(+)淋巴细胞增殖性疾病的临床和病理证据、无其他皮肤T细胞淋巴瘤变体病史且未对指数部位进行过先前放射治疗的患者。
患者的中位年龄为50.5岁(范围15 - 83岁)。治疗病变的中位大小为2.5厘米(范围2 - 7厘米)。4个部位接受单次750 - 800厘戈瑞照射(n = 3),8个部位接受4000 - 4500厘戈瑞、分200 - 250厘戈瑞剂量的多次照射(n = 3)。采用电子线和填充物进行放射治疗。中位随访时间为113个月(范围16 - 147个月)。所有部位均出现100%完全缓解,伴有1 - 2级急性皮炎。
对于复发性且未接受过放射治疗的有症状CD30(+)淋巴细胞增殖性疾病病变,姑息性放射治疗显示出良好的反应。单次750 - 800厘戈瑞照射与多次照射疗程效果相同且更方便。