Georgakopoulos Ioannis, Papadavid Evaggelia, Platoni Kalliopi, Dilvoi Maria, Patatoukas George, Kypraiou Efrosyni, Nikolaou Vasiliki, Efstathopoulos Efstathios, Kelekis Nikolaos, Kouloulias Vasilios
National Kapodistrian University of Athens, Medical School, 2nd Dpt Radiology, Radiotherapy Unit, ATTIKON University Hospital, Athens, Greece.
National Kapodistrian University of Athens, Medical School, 2nd Dermatology Clinic, ATTIKON University Hospital, Athens, Greece.
Clin Transl Radiat Oncol. 2018 Dec 6;15:26-30. doi: 10.1016/j.ctro.2018.12.002. eCollection 2019 Feb.
BACKGROUND & PURPOSE: Although rare, cutaneous lymphomas represent a separate entity in hematologic oncology. T cell origin lymphomas are most common, with Mycosis Fungoides (MF) accounting for about 50-70% of cases. Sezary Syndrome (SS), which represents the leukemic varian of MF, accounts for 3% of Cutaneous T Cell Lymphomas (CTCL). Total Skin Electron Beam Therapy (TSEB) is included at the mainstream of treatment choices for CTCL. The scope of this study is to evaluate the effectiveness and toxicity of two treatment schedules of TSEB.
We report our experience with TSEB in the management of MF and SS, as of 14 patients treated in our institution from 2011 to 2015. 8 patients received the 12 Gy (low dose) scheme while 6 patients were managed with 36 Gy (standard or full dose scheme) according to six dual field Stanford technique. The endpoints were overall response rate, duration of response and toxicity of treatment.
After a median follow up of 2.5 years we noted excellent treatment outcome, with both schemes being well tolerated and resulting in comparable response rates. The overall response rate for both treatment regimens was over 87.5%. Treatment was well tolerated with mild toxicity.
The role of TSEB in the management of MF and SS is well established. The low dose TSEB schedule of 12 Gy is an effective treatment option, since therapeutic results are more than acceptable, compliance is excellent and toxicity is minimal. Moreover, the evidence that it can be repeated safely makes it more attractive than the standard 36 Gy scheme, when a patient is referred to radiation treatment according to treatment guidelines.
皮肤淋巴瘤在血液肿瘤学中虽属罕见，但却是一个独立的病种。T细胞起源的淋巴瘤最为常见，蕈样肉芽肿（MF）约占病例的50 - 70%。 Sézary综合征（SS）是MF的白血病变异型，占皮肤T细胞淋巴瘤（CTCL）的3%。全身皮肤电子束治疗（TSEB）是CTCL治疗选择的主流方法。本研究旨在评估TSEB两种治疗方案的有效性和毒性。
我们报告了2011年至2015年在我院接受治疗的14例MF和SS患者TSEB治疗的经验。8例患者接受12 Gy（低剂量）方案，6例患者根据斯坦福双野技术接受36 Gy（标准或全剂量方案）治疗。观察终点为总缓解率、缓解持续时间和治疗毒性。
中位随访2.5年后，我们发现治疗效果良好，两种方案耐受性均良好，缓解率相当。两种治疗方案的总缓解率均超过87.5%。治疗耐受性良好，毒性轻微。
TSEB在MF和SS治疗中的作用已得到充分确立。12 Gy的低剂量TSEB方案是一种有效的治疗选择，因为治疗效果令人满意，依从性良好且毒性极小。此外，根据治疗指南，当患者接受放射治疗时，它可以安全重复使用，这使其比标准的36 Gy方案更具吸引力。
