Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Photodermatol Photoimmunol Photomed. 2023 Sep;39(5):435-440. doi: 10.1111/phpp.12873. Epub 2023 Mar 27.
Mycosis fungoides (MF) and Sezary Syndrome are the most common forms of cutaneous T-cell lymphoma. Early-stage MF is known to have an indolent behavior, and the EORTC guidelines recommend treating patients with skin-directed therapies, such as phototherapy, instead of systemic therapies. Phototherapy is a popular therapeutic option, with two commonly used light sources-PUVA and narrow band-nb UVB. PUVA is less commonly used due to its potential carcinogenic role, but it has systemic effects, while nb-UVB has mostly skin-limited effects. There is ongoing debate regarding the role of UVB light, and in 2021, the Cutaneous Lymphoma Italian Study Group reached a consensus on technical schedules for NB-UVB and PUVA for MF. This study aims to analyze and compare the efficacy of the two phototherapy options in treating early-MF patients.
The study included patients diagnosed with stage IA/B MF in the last 10 years, who had at least 12 months of follow-up data and a minimum of 24 phototherapy sessions (PUVA or nb UVB) and treated with topical steroids apart from phototherapy.
Results showed that the two phototherapy options were similarly effective in treating early MF, with no significant differences in clinical response, although PUVA was associated with more adverse effects.
The study provides valuable insights into the use of phototherapy in early MF, and the results can be used to guide treatment decisions and improve patient outcomes.
蕈样肉芽肿(MF)和 Sezary 综合征是最常见的皮肤 T 细胞淋巴瘤形式。早期 MF 具有惰性行为,EORTC 指南建议对患者进行皮肤靶向治疗,如光疗,而不是全身治疗。光疗是一种流行的治疗选择,有两种常用的光源-PUVA 和窄谱 nb-UVB。由于其潜在的致癌作用,PUVA 的使用较少,但它具有全身作用,而 nb-UVB 主要具有皮肤局限性作用。关于 UVB 光的作用一直存在争议,2021 年,意大利皮肤淋巴瘤研究组就 MF 的 NB-UVB 和 PUVA 的技术方案达成共识。本研究旨在分析和比较两种光疗选择在治疗早期 MF 患者中的疗效。
该研究纳入了过去 10 年中被诊断为 IA/B 期 MF 的患者,他们有至少 12 个月的随访数据和至少 24 次光疗(PUVA 或 nb UVB),并且除了光疗外,还接受了局部类固醇治疗。
结果表明,两种光疗选择在治疗早期 MF 方面同样有效,临床反应无显著差异,尽管 PUVA 相关的不良反应更多。
该研究为早期 MF 中的光疗提供了有价值的见解,研究结果可用于指导治疗决策并改善患者预后。