P Ponte1, V Serrão, M Apetato. 1. Department of Dermatology, Hospital dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. pedrofponte@gmail.com
Abstract
INTRODUCTION: 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. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short-term treatment modality for clearing patch-stage MF. The effect of psoralen plus long-wave ultraviolet A (PUVA) in the treatment of patch- and plaque-type MF has also been thoroughly documented. OBJECTIVES: The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early-stage MF. METHODS: We analysed the response to treatment, relapse-free survival and irradiation dose in 114 patients with histologically confirmed early-stage MF (stage IA, IB and IIA). RESULTS: A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient. There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment. CONCLUSIONS: Our results confirm that phototherapy is a safe, effective and well-tolerated, first-line therapy in patients with early-stage cutaneous T-cell lymphoma, with prolonged disease-free remissions being achieved. It suggests that narrowband UVB is at least as effective as PUVA for treatment of early-stage MF.
INTRODUCTION: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. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short-term treatment modality for clearing patch-stage MF. The effect of psoralen plus long-wave ultraviolet A (PUVA) in the treatment of patch- and plaque-type MF has also been thoroughly documented. OBJECTIVES: The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early-stage MF. METHODS: We analysed the response to treatment, relapse-free survival and irradiation dose in 114 patients with histologically confirmed early-stage MF (stage IA, IB and IIA). RESULTS: A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient. There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment. CONCLUSIONS: Our results confirm that phototherapy is a safe, effective and well-tolerated, first-line therapy in patients with early-stage cutaneous T-cell lymphoma, with prolonged disease-free remissions being achieved. It suggests that narrowband UVB is at least as effective as PUVA for treatment of early-stage MF.
Authors: Min Soo Jang; Jae Woo Baek; Jong Bin Park; Dong Young Kang; Jin Seuk Kang; Kee Suck Suh; Sang Tae Kim Journal: Ann Dermatol Date: 2011-11-03 Impact factor: 1.444
Authors: Pablo Luis Ortiz-Romero; Octavio Servitje; María Teresa Estrach; Rosa María Izu-Belloso; Ricardo Fernández-de-Misa; Fernando Gallardo; Noemí López-Martínez; Alejandro Pérez-Mitru Journal: Clinicoecon Outcomes Res Date: 2020-02-12