Low-dose total skin electron beam therapy: Quality of life improvement and clinical impact of maintenance and adjuvant treatment in patients with mycosis fungoides or Sezary syndrome

Strahlenther Onkol. 2020 Jan;196(1):77-84. doi: 10.1007/s00066-019-01517-7. Epub 2019 Oct 7.


Purpose: Total skin electron beam therapy (TSEBT) has proved to be a safe and effective treatment for cutaneous T‑cell lymphomas. Here, we examined the impact of this treatment on patient quality of life and outcome.

Patients and methods: Forty-four patients with mycosis fungoides (MF) or Sezary syndrome (SS) received 48 TSEBT courses with a median dose of 12 Gy within the past 8 years at our institute. Patient and treatment characteristics for these cases as well as the impact of TSEBT on quality of life and duration of response were retrospectively analyzed and compared.

Results: The median modified Severity-Weighted Assessment Tool score before the start of TSEBT was 44. The overall response rate was 88%, with a complete response (CR) rate of 33%. The median follow-up period was 13 months. The median duration of response (DOR) and progression-free survival (PFS) for the entire cohort were 10 months and 9 months, respectively. Patient-reported symptom burden was measured with the Dermatological Life Quality Index and Skindex-29 questionnaires. The mean symptom reductions were 6 ± 8 (P = 0.005) and 21 ± 24 (P = 0.002), respectively. In the Functional Assessment of Cancer Therapy-General Assessment, significant improvements in the emotional (P = 0.03) domains were observed after TSEBT. Patients who received maintenance or adjuvant treatments had a longer PFS (P = 0.01).

Conclusion: TSEBT improved disease symptoms and significantly improved emotional domains of patients' quality of life in patients with MF or SS. In addition, our results indicate that maintenance or adjuvant therapy after TSEBT may improve the PFS.

Keywords: Cutaneous lymphoma; Immunity; Itching; Maintenance therapy; Quality of life.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Electrons / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mycosis Fungoides / psychology
  • Mycosis Fungoides / radiotherapy*
  • Quality of Life / psychology
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Sezary Syndrome / prevention & control
  • Sezary Syndrome / radiotherapy*
  • Skin / radiation effects*
  • Skin Neoplasms / psychology
  • Skin Neoplasms / radiotherapy*