Richard T Hoppe1, Cameron Harrison2, Mahkam Tavallaee2, Sameer Bashey2, Uma Sundram3, Shufeng Li2, Lynn Million4, Bouthaina Dabaja5, Pamela Gangar6, Madeleine Duvic6, Youn H Kim2. 1. Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California. Electronic address: rhoppe@stanford.edu. 2. Department of Dermatology, Stanford Cancer Institute, Stanford, California. 3. Department of Dermatology, Stanford Cancer Institute, Stanford, California; Department of Pathology, Stanford Cancer Institute, Stanford, California. 4. Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California. 5. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas. 6. Department of Dermatology, MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Standard-dose (36-Gy) total skin electron beam therapy (TSEBT) is a highly effective treatment in mycosis fungoides. However, the regimen is time-intensive and may be associated with significant toxicity. OBJECTIVE: We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT. METHODS: Data from 3 clinical trials using low-dose (12-Gy) TSEBT were pooled. In all trials, TSEBT-naïve patients with stage IB to IIIA mycosis fungoides were treated with TSEBT (12 Gy, 1 Gy per fraction over 3 weeks). The primary end point was clinical response rate. Secondary end points included time to response and duration of clinical benefit. RESULTS: In all, 33 patients enrolled. Eighteen were male; stages were 22 IB, 2 IIA, 7 IIB, and 2 IIIA. Overall response rate was 88% (29/33), including 9 patients with complete response. Median time to response was 7.6 weeks (3-12.4 weeks). Median duration of clinical benefit was 70.7 weeks (95% confidence interval 41.8-133.8 weeks). Toxicities from TSEBT were mild and reversible. LIMITATIONS: Conclusions are limited because of the small number of patients. CONCLUSIONS: Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with mycosis fungoides, which could be administered safely multiple times during the course of a patient's disease with acceptable toxicity profile.
BACKGROUND: Standard-dose (36-Gy) total skin electron beam therapy (TSEBT) is a highly effective treatment in mycosis fungoides. However, the regimen is time-intensive and may be associated with significant toxicity. OBJECTIVE: We sought to evaluate the efficacy and tolerability associated with low-dose (12-Gy) TSEBT. METHODS: Data from 3 clinical trials using low-dose (12-Gy) TSEBT were pooled. In all trials, TSEBT-naïve patients with stage IB to IIIA mycosis fungoides were treated with TSEBT (12 Gy, 1 Gy per fraction over 3 weeks). The primary end point was clinical response rate. Secondary end points included time to response and duration of clinical benefit. RESULTS: In all, 33 patients enrolled. Eighteen were male; stages were 22 IB, 2 IIA, 7 IIB, and 2 IIIA. Overall response rate was 88% (29/33), including 9 patients with complete response. Median time to response was 7.6 weeks (3-12.4 weeks). Median duration of clinical benefit was 70.7 weeks (95% confidence interval 41.8-133.8 weeks). Toxicities from TSEBT were mild and reversible. LIMITATIONS: Conclusions are limited because of the small number of patients. CONCLUSIONS: Low-dose TSEBT provides reliable and rapid reduction of disease burden in patients with mycosis fungoides, which could be administered safely multiple times during the course of a patient's disease with acceptable toxicity profile.
Authors: M Kinoshita-Ise; T Ouchi; E Izumi; O Kawaguchi; K Nagao; M Amagai; T Funakoshi Journal: Clin Exp Dermatol Date: 2017-12-21 Impact factor: 3.470
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Authors: Wen-Kai Weng; Sally Arai; Andrew Rezvani; Laura Johnston; Robert Lowsky; David Miklos; Judith Shizuru; Lori Muffly; Everett Meyer; Robert S Negrin; Erica Wang; Timothy Almazan; Lynn Million; Michael Khodadoust; Shufeng Li; Richard T Hoppe; Youn H Kim Journal: Blood Adv Date: 2020-09-22
Authors: C Hosing; R Bassett; B Dabaja; R Talpur; A Alousi; S Ciurea; U Popat; M Qazilbash; E J Shpall; Y Oki; Y Nieto; C Pinnix; M Fanale; F Maadani; M Donato; R Champlin; M Duvic Journal: Ann Oncol Date: 2015-09-28 Impact factor: 32.976