Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Indian J Dermatol Venereol Leprol. 2021 Sep-Oct;87(5):645-650. doi: 10.25259/IJDVL_555_19.
Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. Narrowband ultraviolet B and psoralen and ultraviolet A are effective treatment options, but studies of their treatment efficacy and disease relapse remain limited.
This study aimed (1) to determine the efficacy of narrowband ultraviolet B and psoralen and ultraviolet A as a treatment for early-stage mycosis fungoides and explore the predictive factors for complete remission and (2) to determine the relapse rate and analyze their predictive factors, including the utility of maintenance therapy.
This was a retrospective cohort study consisting of 61 patients with early-stage mycosis fungoides (IA - IB) treated with narrowband ultraviolet B or psoralen and ultraviolet A as the first-line therapy from January 2002 to December 2018 at the Division of Dermatology, Ramathibodi Hospital, Bangkok, Thailand. Cox regression analysis and Kaplan-Meier survival curve were performed for the main outcomes.
A complete remission was achieved by 57 (93.5%) patients. The median time to remission was 7.80 ± 0.27 months. Types of phototherapy (narrowband ultraviolet B or psoralen and ultraviolet A), age and gender did not associate with time to remission, while the presence of poikiloderma and higher disease stage led to a longer time to remission. The cumulative incidence of relapse was 50.8%. The median time to relapse was 24.78 ± 5.48 months. In patients receiving phototherapy during the maintenance period, a treatment duration longer than six months was associated with a significantly longer relapse-free interval.
Narrow-band-ultraviolet B and psoralen and ultraviolet A are effective treatment options for early-stage mycosis fungoides. Maintenance treatment by phototherapy for at least six months seems to prolong remission.
蕈样肉芽肿是最常见的皮肤 T 细胞淋巴瘤。窄谱中波紫外线和光化学疗法是有效的治疗选择，但关于其疗效和疾病复发的研究仍然有限。
本研究旨在（1）确定窄谱中波紫外线和光化学疗法治疗早期蕈样肉芽肿的疗效，并探讨完全缓解的预测因素；（2）确定复发率，并分析其预测因素，包括维持治疗的效用。
这是一项回顾性队列研究，纳入了 2002 年 1 月至 2018 年 12 月在泰国曼谷 Ramathibodi 医院皮肤科接受窄谱中波紫外线或光化学疗法作为一线治疗的 61 例早期蕈样肉芽肿（IA-IB）患者。主要结局采用 Cox 回归分析和 Kaplan-Meier 生存曲线进行分析。
57 例（93.5%）患者达到完全缓解。缓解的中位时间为 7.80±0.27 个月。光疗类型（窄谱中波紫外线或光化学疗法）、年龄和性别与缓解时间无关，而斑驳皮肤和较高疾病分期与缓解时间较长相关。复发的累积发生率为 50.8%。复发的中位时间为 24.78±5.48 个月。在维持治疗期间接受光疗的患者中，治疗时间超过 6 个月与无复发生存期显著延长相关。
窄谱中波紫外线和光化学疗法是治疗早期蕈样肉芽肿的有效方法。维持治疗至少 6 个月的光疗似乎可以延长缓解期。
