Wu Susan Y, Damron Ethan P, Xu Jie, Fang Penny Q, Dai Julia, Nair Ranjit, Malpica Castillo Luis E, Fayad Luis E, Torres-Cabala Carlos A, Medeiros L Jeffrey, Vega Francisco, Miranda Roberto N, Duvic Madeleine, Pinnix Chelsea C, Dabaja Bouthaina S, Iyer Swaminathan P, Huen Auris O, Gunther Jillian R
Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
The University of Texas Health Science Center at Houston, Houston, TX, USA.
Int J Dermatol. 2025 Feb;64(2):385-389. doi: 10.1111/ijd.17352. Epub 2024 Jul 2.
Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD) is an increasingly recognized entity with heterogeneous management strategies that may include radiotherapy.
Our aim was to characterize treatment options for PCSM-LPD, with a focus on the role of radiotherapy.
This is a retrospective review of 46 patients seen in the Cutaneous Lymphoma Program at the University of Texas MD Anderson Cancer Center, with a clinicopathologic review consistent with PCSM-LPD. All patients were biopsied and underwent observation, topical/intralesional steroids, and/or radiotherapy. Patients were confirmed to have residual disease prior to radiotherapy.
All patients achieved a complete response (CR). Sixteen patients (35%) received focal radiotherapy, with a CR in 15 (94%). The CR rate following ultra-low-dose radiotherapy (4 Gy in 1-2 fractions) was 92%. There was no grade 3 toxicity after radiotherapy. Thirty patients were managed without radiotherapy, with excision and observation or steroids.
Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder has excellent outcomes, and management strategies may include observation following biopsy, steroids, or radiation. Ultra-low-dose radiotherapy results in excellent outcomes with limited toxicity and is effective for persistent lesions after steroidal therapy.
原发性皮肤CD4+小/中T细胞淋巴增殖性疾病（PCSM-LPD）是一种越来越被认可的疾病，其治疗策略具有异质性，可能包括放疗。
我们的目的是描述PCSM-LPD的治疗选择，重点关注放疗的作用。
这是一项对德克萨斯大学MD安德森癌症中心皮肤淋巴瘤项目中46例患者的回顾性研究，其临床病理检查结果符合PCSM-LPD。所有患者均接受活检，并接受观察、局部/病灶内类固醇治疗和/或放疗。患者在放疗前被确认有残留病灶。
所有患者均达到完全缓解（CR）。16例患者（35%）接受了局部放疗，其中15例（94%）达到CR。超低剂量放疗（1-2次分割，共4 Gy）后的CR率为92%。放疗后无3级毒性反应。30例患者未接受放疗，采用手术切除并观察或使用类固醇治疗。
原发性皮肤CD4+小/中T细胞淋巴增殖性疾病预后良好，治疗策略可能包括活检后观察、使用类固醇或放疗。超低剂量放疗可带来良好的治疗效果，毒性有限，对类固醇治疗后持续存在的病灶有效。
