A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides

Journal Article · Thu Dec 28 00:00:00 EST 1989 · New England Journal of Medicine; (USA)

DOI:https://doi.org/10.1056/NEJM198912283212603· OSTI ID:7018637

Kaye, F J; Bunn, Jr, P A; Steinberg, S M; Stocker, J L; Ihde, D C; Fischmann, A B; Glatstein, E J; Schechter, G P; Phelps, R M; Foss, F M

Mycosis fungoides is a T-cell lymphoma that arises in the skin and progresses at highly variable rates. Nonradomized studies have suggested that early aggressive therapy may improve the prognosis in this usually fatal disease. We studied 103 patients with mycosis fungoides, who, after complete staging, were randomly assigned to receive either combination therapy, consisting of 3000 cGy of electron-beam radiation to the skin combined with parenteral chemotherapy with cyclophosphamide, doxorubicin, etoposide, and vincristine (n = 52) or sequential topical treatment (n = 51). The prognostic factors were well balanced in the two groups. Combined therapy produced considerable toxicity: 12 patients required hospitalization for fever and transient neutropenia, 5 had congestive heart failure, and 2 were later found to have acute nonlymphocytic leukemia. Patients receiving combined therapy had a significantly higher rate of complete response, documented by biopsy, than patients receiving conservative therapy (38 percent vs. 18 percent; P = 0.032). After a median follow-up of 75 months, however, there was no significant difference between the treatment groups in disease-free or overall survival. We conclude that early aggressive therapy with radiation and chemotherapy does not improve the prognosis for patients with mycosis fungoides as compared with conservative treatment beginning with sequential topical therapies.

• OSTI ID: 7018637
• Journal Information: New England Journal of Medicine; (USA), Vol. 321:26; ISSN 0028-4793
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
COMBINED THERAPY
SIDE EFFECTS
LYMPHOMAS
SKIN
ANTINEOPLASTIC DRUGS
COMPARATIVE EVALUATIONS
ELECTRON BEAMS
PATIENTS
SURVIVAL CURVES
TOXICITY
BEAMS
BODY
DISEASES
DRUGS
IMMUNE SYSTEM DISEASES
LEPTON BEAMS
NEOPLASMS
ORGANS
PARTICLE BEAMS
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)
550600 - Medicine