Outcome of Patients Treated With a Single-Fraction Dose of Palliative Radiation for Cutaneous T-Cell Lymphoma

e19505 Background: Primary cutaneous lymphomas occur in 0.5 to 1 per 100,000 people every year in developed countries. Less than 1,000 cases of Mycosis Fungoides are diagnosed each year in the United States, with approximately 3 cases per 1,000,000 per year. Cutaneous T-cell lymphomas are responsive to radiation therapy, and local radiation therapy, total skin electron beam therapy, phototherapy (with UVB or PUVA), chemotherapy agents (nitrogen mustards, BCNU), retinoids, and steroids have all been used with varying degrees of success. Methods: This is a retrospective review of all cases of histology-proven cutaneous T-cell lymphoma treated with single-fraction radiation therapy at Northwestern Memorial Hospital in the Department of Radiation Oncology since 1990. We looked at response to treatment and local control. We reviewed the charts of 67 patients with cutaneous T-cell lymphoma, of which 40 patients and a total of 130 sites of disease received single-fraction radiation therapy and had available follow-up data. Results: Of the 130 lesions receiving a single-fraction of radiation, 86 (66%) received 800cGy in 1 fraction and 38 (29%) received 700cGy. 4 patients (3%) received 750cGy, 1 (<1%) received 550cGy and 1 (<1%) received 500cGy. Patients were treated with electron energies ranging from 6–18 MeV or photon energies ranging from 4–10 MV. Out of 130 lesions, 119 (92%) achieved a complete response (CR) to single-fraction radiation and 11 (8%) achieved a partial response (PR). There were 2 sites of relapse out of 130 treated sites, involving 2 patients. The median follow-up time was 4 months, mean follow-up time was 14 months, and 44% of patients had greater than 6 months of follow-up. Conclusions: This review of the experience at our institution since 1990 shows single-fraction radiation therapy to be an effective treatment for cutaneous T-cell lymphoma, with high response rates and very low relapse rates. No significant financial relationships to disclose.

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Single-Fraction Radiation Therapy Provides Highly Effective Palliation for Cutaneous T-cell Lymphoma

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.06.1863 ◽

2016 ◽

Vol 96 (2) ◽

pp. E492

Author(s):

A. Modh ◽

C.A. McHargue ◽

H. Lim ◽

F. Siddiqui

Keyword(s):

Radiation Therapy ◽

T Cell ◽

Cell Lymphoma ◽

T Cell Lymphoma ◽

Cutaneous T Cell Lymphoma ◽

Single Fraction ◽

Highly Effective

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Single-Fraction Radiotherapy for CD30+Lymphoproliferative Disorders

BioMed Research International ◽

10.1155/2015/629587 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 7

Author(s):

Michelle S. Gentile ◽

Maria Estela Martinez-Escala ◽

Tarita O. Thomas ◽

Joan Guitart ◽

Steven Rosen ◽

...

Keyword(s):

Radiation Therapy ◽

T Cell ◽

Lymphoproliferative Disorder ◽

Cell Lymphoma ◽

Complete Response ◽

Cutaneous T Cell Lymphoma ◽

First Line ◽

Single Fraction ◽

Palliative Radiation ◽

Palliative Radiation Therapy

Objectives. CD30+lymphoproliferative disorder is a rare variant of cutaneous T-cell lymphoma. Sustained complete response following first-line treatments is rare. This retrospective review evaluates the response of refractory or recurrent lesions to palliative radiation therapy.Methods. The records of 6 patients with 12 lesions, treated with radiation therapy, were reviewed. All patients received previous first-line treatments. Patients with clinical and pathological evidence of symptomatic CD30+lymphoproliferative disorder, with no history of other cutaneous T-cell lymphoma variants, and with no prior radiation therapy to the index site were included.Results. The median age of patients was 50.5 years (range, 15–83 years). Median size of the treated lesions was 2.5 cm (range, 2–7 cm). Four sites were treated with a single fraction of 750–800 cGy (n=3) and 8 sites were treated with 4000–4500 cGy in 200–250 cGy fractions (n=3). Radiation therapy was administered with electrons and bolus. Median follow-up was 113 months (range, 16–147 months). For all sites, there was 100% complete response with acute grade 1-2 dermatitis.Conclusions. For recurrent and symptomatic radiation-naïve CD30+lymphoproliferative disorder lesions, palliative radiation therapy shows excellent response. A single fraction of 750–800 cGy is as effective as a multifractionated course and more convenient.

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