Jang Bum-Sup, Kim Eunji, Kim Il Han, Kang Hyun-Cheol, Ye Sung-Joon
Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.
Institute of Radiation Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2018 Jun;36(2):153-162. doi: 10.3857/roj.2017.00542. Epub 2018 Jun 29.
We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. Materials and.
Total 19 patients confirmed with MF between 1999-2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed.
Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT.
Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.
我们旨在评估蕈样肉芽肿(MF)患者接受放射治疗(RT)后的临床结局,包括无进展生存期(PFS)、总生存期(OS)、部分缓解和完全缓解。此外,我们试图找出临床结局的预后因素。材料与方法:回顾性分析了1999年至2015年间确诊为MF的19例患者。分析了临床和治疗特征、临床结局及毒性反应。结果:11例患者接受了全身皮肤电子束放疗(TSEBT),8例患者接受了受累野放射治疗(IFRT),中位剂量分别为30 Gy。从诊断到放疗的中位时间间隔为2.6个月(范围0.4至87.3个月)。总缓解率为100%;11例患者(57.9%)完全缓解,8例患者(42.1%)部分缓解。放疗会诊时存在阳性淋巴结与较低的总生存期相关(p = 0.043)。多因素分析显示,放疗后既往治疗次数增加的患者无进展生存期显著降低(p = 0.019),放疗期间出现部分缓解的患者无进展生存期也显著降低(p = 0.044)。未报告与放疗相关的3级或更高级别的皮肤毒性反应。结论:IFRT和TSEBT对MF患者均为有效的治疗方法。放疗前病程短或放疗期间完全缓解的患者预计无进展生存期更长。放疗开始时阳性淋巴结状态与较差的总生存期相关,提示对于预期寿命较低的患者可采用低剂量放疗等其他治疗方式。