Kim Ha Un, Kim Yeon Joo, Lee Mi Woo, Lee Woo Jin, Lee Sang-Wook, Song Youngju, Cho Byungchul, Song Si Yeol
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Radiat Oncol J. 2024 Sep;42(3):228-236. doi: 10.3857/roj.2024.00444. Epub 2024 Sep 24.
To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).
We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.
Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.
Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.
评估皮肤定向放疗（RT）治疗原发性皮肤T细胞淋巴瘤（CTCL）的疗效和毒性。
我们回顾性分析了2000年1月至2022年12月期间接受皮肤定向放疗的57例CTCL病变。病变分为三个不同组：局部放疗治疗的早期疾病、局部放疗治疗的晚期疾病以及全身皮肤电子束治疗（TSEBT）治疗的晚期疾病。评估每组的治疗结果，包括缓解率、复发模式和局部进展概率。
蕈样肉芽肿（MF）占晚期病理类型的90.9%，而CD4 +原发性皮肤小/中型T细胞淋巴增殖性疾病在早期病变中常见（55%）。早期局部放疗、晚期局部放疗和晚期TSEBT的中位放疗剂量分别为30.6 Gy、27 Gy和32 Gy。各组的完全缓解率都很高：分别为95.5%、70.8%和90.9%。晚期局部放疗组发生7例局部复发（29.2%），而TSEBT组有7例患者（63.6%）出现局部失败。所有复发均见于MF病变和患者。急性毒性主要为1级或2级，无3级或更高等级事件。未发现放疗剂量与MF病变局部进展率之间存在显著关联。
CTCL的皮肤定向放疗对局部控制有效，耐受性良好，毒性较小。
