Herrmann J J, Roenigk H H, Hurria A, Kuzel T M, Samuelson E, Rademaker A W, Rosen S T
Department of Dermatology, Robert H. Lurie Cancer Center, Chicago, IL, USA.
J Am Acad Dermatol. 1995 Aug;33(2 Pt 1):234-42. doi: 10.1016/0190-9622(95)90241-4.
Mycosis fungoides (MF) is a non-Hodgkin's T-cell lymphoma of the skin that often begins as limited patches and plaques with slow progression to systemic involvement. No studies have been published comparing photochemotherapy (PUVA) with other topical therapies in the treatment of early-stage disease.
The purpose of the study was to examine our long-term experience using PUVA to treat early-stage MF and to compare its effectiveness and side-effect profile with other previously reported topical therapies.
Eighty-two patients with MF (83% stage IA or IB) were treated with PUVA. Clinical and histologic features were observed for a period from 2 months to 15 years (median, 43 months).
A response was noted in 78 patients (95%) with complete clinical and histologic clearing in 53 patients (65%) for all stages. The mean duration of total complete response to PUVA for all stages was 43 months (3.6 years). The mean survival of our study group for all stages was 8.5 years. Signs of chronic actinic skin damage were found in 10% of patients, including three patients with basal cell carcinomas and three patients with squamous cell carcinomas. In a nonrandomized comparison with previously reported data for other topical therapies, the efficacy and side-effect profile of PUVA compared favorably.
PUVA is an effective and safe therapy for MF with prolonged disease-free remissions being achieved. Patients with stage I and II MF respond best to PUVA. Palliative therapy with PUVA is useful in more advanced cases of MF.
蕈样肉芽肿（MF）是一种皮肤非霍奇金T细胞淋巴瘤，通常始于局限性斑片和斑块，进展缓慢，可累及全身。尚无研究发表比较光化学疗法（PUVA）与其他局部疗法治疗早期疾病的效果。
本研究旨在探讨我们使用PUVA治疗早期MF的长期经验，并将其有效性和副作用情况与其他先前报道的局部疗法进行比较。
82例MF患者（83%为IA期或IB期）接受了PUVA治疗。观察临床和组织学特征2个月至15年（中位时间为43个月）。
78例患者（95%）有反应，所有阶段中53例患者（65%）临床和组织学完全清除。所有阶段对PUVA完全反应的平均持续时间为43个月（3.6年）。我们研究组所有阶段的平均生存期为8.5年。10%的患者出现慢性光化性皮肤损伤迹象，包括3例基底细胞癌患者和3例鳞状细胞癌患者。与先前报道的其他局部疗法的数据进行非随机比较时，PUVA的疗效和副作用情况表现良好。
PUVA是一种治疗MF的有效且安全的疗法，可实现长期无病缓解。I期和II期MF患者对PUVA反应最佳。PUVA姑息治疗对更晚期的MF病例有用。
