Skin-directed radiation therapy for cutaneous lymphoma: The Mayo Clinic experience

J Am Acad Dermatol. 2020 Mar;82(3):634-641. doi: 10.1016/j.jaad.2019.07.040. Epub 2019 Jul 22.

Abstract

Background: Focal or total skin radiation therapy can be used to treat mild to refractory cutaneous T-cell lymphoma.

Objective: To report the broad therapeutic benefit of radiation therapy for cutaneous T-cell lymphoma.

Methods: Retrospective, single-institution review of outcomes for skin-directed radiation therapy.

Results: Skin-directed radiation therapy showed a 99% response rate and 80% complete response rate after treatment regardless of involvement, severity, histopathologic subtype, dose, or fractionation. The overall in-field recurrence rate was 15%, and median time to recurrence was 296 days (range, 1-1884 days). Focal and hypofractionated regimens were similarly associated with disease response and rare toxicity. Short-term rates of secondary skin cancer after treatment were comparable to expected incidence in a patient population without radiation.

Limitations: Large total number of treatments courses compared with overall number of patients. Heterogenous mix of treatment regimens (no standardization of dose or fraction number).

Conclusions: Radiation therapy is a well-tolerated treatment option for properly selected patients with cutaneous T-cell lymphoma.

Keywords: cutaneous T-cell lymphoma; radiation therapy.

MeSH terms

  • Aged
  • Female
  • Humans
  • Lymphoma, T-Cell, Cutaneous / radiotherapy*
  • Male
  • Radiotherapy / methods
  • Retrospective Studies
  • Skin
  • Skin Neoplasms / radiotherapy*
  • Treatment Outcome