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蕈样肉芽肿的全身皮肤电子束治疗

[Total cutaneous electron beam therapy of mycosis fungoides].

作者信息

Le Bourgeois J P, Levy E, Haddad E, Marinello G, Geara F, Pavlovitch J M

机构信息

Département de cancérologie, Hôpital Henri Mondor, Créteil.

出版信息

Ann Dermatol Venereol. 1989;116(3):213-7.

PMID:2662874
Abstract

Electron beam irradiation of the entire skin surface was used to treat 25 patients with mycosis fungoides from 1977 to January 1988. A plexiglas screen was used to reduce the energy of the 8 MeV beam of a Sagittaire linear accelerator to 4 MeV. A total dose of 30 Gy was delivered in 12 fractions over days. This series includes 17 men and 8 women with a mean age of 44 years (range 13-78 years) and a mean follow-up of 34 months (range 6-92 months). The following-up staging system was used: stage A: superficial lesions covering less than 50 p. 100 of the body surface; stage B: superficial lesions covering more than 50 p. 100 of the body surface; stage C: tumors of the skin, lymph nodes and/or visceral organs, Sezary's syndrome. All stage A patients achieved complete remission. One developed recurrent disease in a very limited area 17 months after radiation therapy. No stage A patient died of mycosis fungoides. 6/9 stage B patients achieved complete remission; 4 of these developed recurrent disease localized to the skin 6 to 13 months after electron therapy. These recurrences were controlled by topical nitrogen mustard, puva therapy or localized irradiation. 1 patient showed no response and died of cutaneous mycosis fungoides. 5/10 stage C patients obtained complete remission but all relapsed within a mean period of 7 months. 4/5 of the patients not responding to electron therapy died of their disease and one is alive 16 months after completion of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1977年至1988年1月期间,采用电子束照射整个皮肤表面的方法治疗了25例蕈样肉芽肿患者。使用一块有机玻璃屏将Sagittaire直线加速器的8兆电子伏束流能量降至4兆电子伏。在数天内分12次给予总剂量30戈瑞。该系列包括17名男性和8名女性,平均年龄44岁(范围13 - 78岁),平均随访34个月(范围6 - 92个月)。采用以下随访分期系统:A期:浅表病变覆盖体表面积小于50%;B期:浅表病变覆盖体表面积超过50%;C期:皮肤、淋巴结和/或内脏器官肿瘤,塞扎里综合征。所有A期患者均实现完全缓解。1例患者在放疗后17个月于非常有限的区域出现复发性疾病。没有A期患者死于蕈样肉芽肿。9例B期患者中有6例实现完全缓解;其中4例在电子治疗后6至13个月出现局限于皮肤的复发性疾病。这些复发通过局部使用氮芥、光化学疗法或局部照射得到控制。1例患者无反应,死于皮肤蕈样肉芽肿。10例C期患者中有5例获得完全缓解,但均在平均7个月内复发。5例对电子治疗无反应的患者中有4例死于该病,1例在治疗结束后16个月仍存活。(摘要截短至250字)

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