Nikolaou Vasiliki, Sachlas Athanasios, Papadavid Evangelia, Economidi Afroditi, Karambidou Konstantina, Marinos Leonidas, Stratigos Alexander, Antoniou Christina
Cutaneous Lymphoma Clinic, A. Sygros Hospital for skin diseases, National & Kapodestrian University of Athens Medical School, Athens, Greece.
Department of Statistics and Insurance Science, University of Piraeus, Athens, Greece.
Photodermatol Photoimmunol Photomed. 2018 Sep;34(5):307-313. doi: 10.1111/phpp.12383. Epub 2018 Jun 21.
Phototherapy is one of the main treatments for mycosis fungoides (MF). In this study, we analyzed the efficacy and safety of phototherapy as a first-line treatment in patients with early-stage disease.
We analyzed treatment outcomes in a group of 227 early-stage patients. The chi-squared test, the parametric t test, and ANOVA test and the non-parametric tests of Mann-Whitney and Kruskal-Wallis were applied for data analysis.
55.9% of patients treated with UVB-NB reached complete remission (CR), while analog rates after PUVA treatment were 74.5% (P = .015). Patients with patch-stage disease showed better response rates to PUVA compared to UVB-NB therapy (CRs 56.7% vs 91.3%, P < .001). Regarding the latter, long-lasting disease was proven as an independent negative prognostic factor for treatment outcome. Phototypes I and II were found to be favorable prognostic factors for patients treated with PUVA. Maintenance treatment did not alter final relapse rates but led to prolonged time to relapse compared to no-maintenance treated cases (19.5 months, vs 32.3, P < .002).
Our analysis indicates that PUVA leads to better responses and longer relapse-free intervals both in patch- and plaque-stage disease. UVB-NB could be a valid therapeutic alternative for patients with recent disease presentation.
光疗是蕈样肉芽肿（MF）的主要治疗方法之一。在本研究中，我们分析了光疗作为早期疾病患者一线治疗的疗效和安全性。
我们分析了一组227例早期患者的治疗结果。采用卡方检验、参数t检验、方差分析以及Mann-Whitney和Kruskal-Wallis非参数检验进行数据分析。
接受窄谱中波紫外线（UVB-NB）治疗的患者中有55.9%达到完全缓解（CR），而补骨脂素加紫外线A（PUVA）治疗后的类似缓解率为74.5%（P = 0.015）。与UVB-NB治疗相比，斑块期疾病患者对PUVA的反应率更高（CR分别为56.7%和91.3%，P < 0.001）。对于后者，疾病持续时间长被证明是治疗结果的独立负性预后因素。发现光型I和II是接受PUVA治疗患者的有利预后因素。与未进行维持治疗的病例相比，维持治疗并未改变最终复发率，但延长了复发时间（19.5个月对32.3个月，P < 0.002）。
我们的分析表明，PUVA在斑块期和斑片期疾病中均能产生更好的反应和更长的无复发间隔。UVB-NB对于近期发病的患者可能是一种有效的治疗选择。
