Mycosis fungoides. Electron beam therapy

Area of Science:

• Oncology
• Radiation Oncology
• Dermatology

Background:

• Mycosis fungoides is a type of T-cell lymphoma affecting the skin.
• Late-stage mycosis fungoides often requires advanced treatment modalities.
• Total skin electron beam therapy (TSEBT) is a recognized treatment for advanced disease.

Purpose of the Study:

• To describe the adaptation and application of total skin electron beam therapy (TSEBT) at Hammersmith Hospital for treating late-stage mycosis fungoides.
• To outline the treatment parameters and patient management strategies.
• To discuss the efficacy and effects of this therapeutic approach.

Main Methods:

• Adaptation of the electron beam with carbon and copper scatterers to achieve specific depth doses.
• Irradiation of patients with advanced mycosis fungoides who have not responded to conservative treatments.
• Administration of doses ranging from 1500 to 2600 rads over 10-13 fractions within 5-7 weeks.

Main Results:

• The modified electron beam delivers an 80% depth dose at 5.5, 8, and 11.5 mm below the skin surface.
• Higher dose ranges have been employed recently.
• Lithium fluoride dosimetry studies indicate skin doses are approximately double the prescribed dose when using four treatment fields.

Conclusions:

• Total skin electron beam therapy, as adapted at Hammersmith Hospital, is an effective treatment for advanced mycosis fungoides.
• The described method allows for precise dose delivery and management of patients with challenging skin conditions.
• Further research into dose optimization and long-term effects is warranted.