Total skin electron beam therapy (TSEBT)‎ in the management of mycosis fungoides: single institution experience

Abstract EN

Purpose : to describe a protocol for total skin electron beam therapy (TSEBT) for the treatment of patients with mycosis fungicides (MF).

We report the results of treatment and prognostic factors affecting the disease-free survival (DFS).

Patients and methods: A total of 40 patients with the diagnosis of T1 / T2 mycosis fungicides have been referred to the Department of Radiation Oncology at National Cancer Institute of Cairo University from August 1997 till March 2002.

They were treated with TSEBT provided via a 6-Mev Lilac to a total absorbed dose of 35 Gy over 10 weeks.

Response rate, disease-free survival and treatment toxicity were assessed.

Results: The average age was 50 years and the median duration of skin lesions prior to any specific treatment was 4 years.

Thirty-four patients (85 %) had T1-T2 tumors.

Only 17.5 % of patients did not receive any specific treatment prior to TSEBT.

Response 4-5 weeks after end of TSEBT showed complete clinical response (CR) in 87.5 % of patients.

The median follow-up was 19.5 months, only 11 patients (27.5 %) with intial CR continued to be free of disease untill last follow-up.

The overall 2-year disease-free survival (DFS) was 66 %.

Univariate analysis showed that age, performance status and T-stage were statistically significant prognostic factors affecting DFS.

Multivariate analysis revealed that T-stage was the only independent significant factor affecting DFS.

Conclusion : for patients with MF confined to the skin, TSEBT is a safe treatment modality and is associated with high complete response (CR) rate and long DFS compared to other known modalities.

The best results can be obtained in newly diagnosed patients without previous specific treatment and T1 disease.