Thatcher R Heumann1, Natia Esiashvili2, Sareeta Parker3, Jeffrey M Switchenko4, Anees Dhabbaan2, Michael Goodman5, Mary Jo Lechowicz6, Christopher R Flowers6, Mohammad K Khan7. 1. Emory University School of Medicine, Emory University, Atlanta, Georgia. 2. Department of Radiation Oncology, Emory University, Atlanta, Georgia; Winship Cancer Institute (WCI), Emory University, Atlanta, Georgia. 3. Department of Dermatology, Emory University, Atlanta, Georgia. 4. Biostatistics Shared Core Resource at WCI, Emory University, Atlanta, Georgia. 5. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. 6. Department of Radiation Oncology, Emory University, Atlanta, Georgia; Department of Hematology and Oncology, Emory University, Atlanta, Georgia. 7. Department of Radiation Oncology, Emory University, Atlanta, Georgia; Winship Cancer Institute (WCI), Emory University, Atlanta, Georgia. Electronic address: drkhurram2000@gmail.com.
Abstract
PURPOSE: To report our experience with rotational total skin electron irradiation (RTSEI) in cutaneous T-cell lymphoma (CTCL), and to examine response by disease stage and race. METHODS AND MATERIALS: We reviewed our outcomes for 68 CTCL patients who received RTSEI (≥ 30 Gy) from 2000 to 2013. Primary outcomes were complete clinical response (CCR), recurrence-free survival (RFS), and overall survival (OS). Using log-rank tests and Cox proportional hazards, OS and RFS were compared across tumor stages at time of RTSEI with further racial subgroup analysis. RESULTS: Median age at diagnosis and at time of radiation was 52 and 56 years, respectively. Median follow-up was 5.1 years, 49% were African American, and 49% were female. At time of treatment, 18, 37, and 13 patients were T stage 2, 3, and 4, respectively. At 6 weeks after RTSEI, overall CCR was 82% (88%, 83%, and 69% for T2, T3, and T4, respectively). Median RFS was 11 months for all patients and 14, 10, and 12 months for stage T2, T3, and T4, respectively. Tumor stage was not associated with RFS or CCR. Maintenance therapy after RTSEI was associated with improved RFS in both crude and multivariable analysis, controlling for T stage. Median OS was 76 months (91 and 59 months for T3 and T4, respectively). With the exception of improved OS in African Americans compared with whites at stage T2, race was not associated with CCR, RFS, or OS. CONCLUSIONS: These results represent the largest RTSEI clinical outcomes study in the modern era using a dual-field rotational technique. Our observed response rates match or improve upon the standard set by previous outcome studies using conventional TSEI techniques, despite a large percentage of advanced CTCL lesions in our cohort. We found that clinical response after RTSEI did not seem to be affected by T stage or race. Published by Elsevier Inc.
PURPOSE: To report our experience with rotational total skin electron irradiation (RTSEI) in cutaneous T-cell lymphoma (CTCL), and to examine response by disease stage and race. METHODS AND MATERIALS: We reviewed our outcomes for 68 CTCLpatients who received RTSEI (≥ 30 Gy) from 2000 to 2013. Primary outcomes were complete clinical response (CCR), recurrence-free survival (RFS), and overall survival (OS). Using log-rank tests and Cox proportional hazards, OS and RFS were compared across tumor stages at time of RTSEI with further racial subgroup analysis. RESULTS: Median age at diagnosis and at time of radiation was 52 and 56 years, respectively. Median follow-up was 5.1 years, 49% were African American, and 49% were female. At time of treatment, 18, 37, and 13 patients were T stage 2, 3, and 4, respectively. At 6 weeks after RTSEI, overall CCR was 82% (88%, 83%, and 69% for T2, T3, and T4, respectively). Median RFS was 11 months for all patients and 14, 10, and 12 months for stage T2, T3, and T4, respectively. Tumor stage was not associated with RFS or CCR. Maintenance therapy after RTSEI was associated with improved RFS in both crude and multivariable analysis, controlling for T stage. Median OS was 76 months (91 and 59 months for T3 and T4, respectively). With the exception of improved OS in African Americans compared with whites at stage T2, race was not associated with CCR, RFS, or OS. CONCLUSIONS: These results represent the largest RTSEI clinical outcomes study in the modern era using a dual-field rotational technique. Our observed response rates match or improve upon the standard set by previous outcome studies using conventional TSEI techniques, despite a large percentage of advanced CTCL lesions in our cohort. We found that clinical response after RTSEI did not seem to be affected by T stage or race. Published by Elsevier Inc.
Authors: P A Quirós; G W Jones; B M Kacinski; I M Braverman; P W Heald; R L Edelson; L D Wilson Journal: Int J Radiat Oncol Biol Phys Date: 1997-07-15 Impact factor: 7.038
Authors: Bradley G Ackerson; Qiuwen Wu; Oana Craciunescu; Taofik Oyekunle; Donna Niedzwiecki; Jennie Gupton; Patrick Laug; Karibee Brumfield; Erin Crain; Colin E Champ; Chris R Kelsey Journal: Adv Radiat Oncol Date: 2021-04-22
Authors: Neil B Newman; Chirayu G Patel; George X Ding; John A Zic; Jeffrey Zwerner; Evan C Osmundson; Austin N Kirschner Journal: J Am Acad Dermatol Date: 2020-12-14 Impact factor: 15.487
Authors: Matthew R Kudelka; Jeffrey M Switchenko; Mary Jo Lechowicz; Natia Esiashvili; Christopher R Flowers; Mohammad K Khan; Pamela B Allen Journal: Clin Lymphoma Myeloma Leuk Date: 2020-06-30
Authors: Hasan H Danish; Thatcher R Heumann; Kyle T Bradley; Jeffrey Switchenko; Natia Esiashvili; Mary Jo Lechowicz; Christopher R Flowers; Mohammad K Khan Journal: Dermatol Ther (Heidelb) Date: 2016-04-16
Authors: K Smits; K D Quint; M H Vermeer; L A Daniëls; R Willemze; P M Jansen; W P A Jansen; K J Neelis Journal: Clin Transl Radiat Oncol Date: 2022-01-18