Skin-directed radiotherapy for primary cutaneous T-cell lymphomas

Area of Science:

• Oncology
• Dermatology
• Radiation Oncology

Background:

• Primary cutaneous T-cell lymphoma (CTCL) is a diverse group of non-Hodgkin lymphomas.
• Skin-directed radiotherapy (RT) is a primary treatment modality for localized CTCL.
• Evaluating RT efficacy and toxicity is crucial for optimizing patient outcomes.

Purpose of the Study:

• To assess the effectiveness and safety of skin-directed RT in treating primary cutaneous T-cell lymphoma (CTCL).
• To compare outcomes for different RT approaches in early and advanced-stage CTCL.

Main Methods:

• Retrospective analysis of 57 CTCL lesions treated with skin-directed RT (2000-2022).
• Lesions grouped into: early-stage local RT, advanced-stage local RT, and advanced-stage total skin electron beam therapy (TSEBT).
• Outcomes assessed included response rates, recurrence patterns, and local progression.

Main Results:

• High complete response rates observed: 95.5% (early local RT), 70.8% (advanced local RT), 90.9% (advanced TSEBT).
• Local recurrences were noted in 29.2% (advanced local RT) and 63.6% (advanced TSEBT) of cases, primarily in Mycosis Fungoides (MF).
• Acute toxicities were predominantly grade 1-2, with no severe events; RT dose did not correlate with local progression in MF.

Conclusions:

• Skin-directed RT demonstrates significant efficacy in achieving local control for CTCL.
• The treatment is well-tolerated, with a favorable toxicity profile.
• RT is a valuable therapeutic option for managing primary cutaneous T-cell lymphoma.