Rationale for curative radiotherapy in mycosis fungoides
From 1958 to 1975, 176 patients with documented mycosis fungoides were treated by total skin electron beam therapy at Stanford University. All patients were classified by the initial extent of skin involvement and staged with respect to overall evidence of disease. The technique of treatment is reviewed. The likelihood of initial complete regression of all skin lesions was inversely related to the initial extent of skin involvement, ranging from 86 percent in the limited plaque to 44 percent in the tumors group. Survival also correlated well with initial extent of skin involvement, with 10-year survivals of 76 percent, 44 percent, and 6 percent in the limited plaque, generalized plaque, and tumorous groups, respectively. Initial stage of disease also had a bearing on prognosis. Five year survivals for Stage I and II patients were 80 and 51 percent, respectively. There were no long-term survivors among patients with Stage III or IV disease. The significance of dermatophathic lymphadenopathy is discussed. Patients who have palpable nodes, even in the absence of their frank involvement by mycosis fungoides have a worse prognosis than patients without lymphadenopathy. Their survival is worse and they have an increased likelihood of extracutaneous spread of mycosis fungoides. The incidence of initial complete remission is directly related to the initial dose of electron beam therapy. Ninety-four percent (51/54) of patients receiving 3000 to 3600 rad entered complete remission, while only 18 percent (3/17) of patients receiving doses of 800 to 1000 rad had complete remission of all disease. Of the 51 patients who entered complete remission after total skin electron beam therapy with doses in excess of 3000 rad, 20 (39 percent) continued to be free of disease 3 to 14 years after completion of therapy.
- Research Organization:
- Stanford Univ. School of Medicine, CA
- OSTI ID:
- 5111736
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 2:9/10
- Country of Publication:
- United States
- Language:
- English
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