Joseph A Miccio1, Lynn D Wilson2, Benjamin H Kann2, Vikram Jairam2, Jason Beckta2, Francine M Foss3,4, Debra N Yeboa5. 1. Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, U.S.A. Joseph.Miccio@yale.edu. 2. Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, U.S.A. 3. Department of Medicine, Yale School of Medicine, New Haven, CT, U.S.A. 4. Department of Dermatology, Yale School of Medicine, New Haven, CT, U.S.A. 5. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, U.S.A.
Abstract
BACKGROUND AND AIM: Radiotherapy is an effective treatment for cutaneous T-cell lymphoma (CTCL). Since 2009, studies have advocated for low-dose radiotherapy (<30 Gy) given it results in similar response rates and less toxicity compared to higher doses (≥30 Gy). We aimed to see if low-dose radiotherapy has been adopted on a national scale in the USA. MATERIALS AND METHODS: A total of 11,292 adult patients with CTCL were identified in the National Cancer Database. Logistic regression models were created to evaluate predictors for use of low-dose radiotherapy. RESULTS: A minority of patients received low-dose radiotherapy (22.4%). The annual percentage of patients receiving low-dose radiotherapy increased from 17.2% in 2009 to 38.4% in 2015. High-volume facilities were associated with use of low-dose radiotherapy (5th quintile vs. bottom two quintiles, odds ratio(OR)=1.76, 95% confidence interval(CI)=1.22-2.54, p=0.003). CONCLUSION: Although the radiotherapy dose administered is decreasing, most patients with CTCL are still receiving doses that may be higher than needed to palliate their disease effectively. Copyright
BACKGROUND AND AIM: Radiotherapy is an effective treatment for cutaneous T-cell lymphoma (CTCL). Since 2009, studies have advocated for low-dose radiotherapy (<30 Gy) given it results in similar response rates and less toxicity compared to higher doses (≥30 Gy). We aimed to see if low-dose radiotherapy has been adopted on a national scale in the USA. MATERIALS AND METHODS: A total of 11,292 adult patients with CTCL were identified in the National Cancer Database. Logistic regression models were created to evaluate predictors for use of low-dose radiotherapy. RESULTS: A minority of patients received low-dose radiotherapy (22.4%). The annual percentage of patients receiving low-dose radiotherapy increased from 17.2% in 2009 to 38.4% in 2015. High-volume facilities were associated with use of low-dose radiotherapy (5th quintile vs. bottom two quintiles, odds ratio(OR)=1.76, 95% confidence interval(CI)=1.22-2.54, p=0.003). CONCLUSION: Although the radiotherapy dose administered is decreasing, most patients with CTCL are still receiving doses that may be higher than needed to palliate their disease effectively. Copyright
Authors: A E Kaufman; K Patel; K Goyal; D O'Leary; N Rubin; D Pearson; K Bohjanen; A Goyal Journal: J Eur Acad Dermatol Venereol Date: 2020-05-24 Impact factor: 6.166