Single-fraction radiation therapy provides highly effective palliation for cutaneous T cell lymphoma

Abstract

Purpose/objective(s)

We report our experience with single-fraction radiation therapy in treating limited extent CTCL lesions for palliation.

Materials/methods

We reviewed 65 lesions in 18 patients with stage IA–IIB CTCL treated with a single fraction at our institution from December 2014 to April 2016. Fifteen patients had mycosis fungoides; all others (three) had primary cutaneous anaplastic large cell lymphoma. Clinical response to treatment was defined as complete response (CR, 90–100% reduction), partial response (PR, >50% but <90%), and no response (NR).

Results

All lesions were treated to a dose of 8 Gy, with a mean follow-up for all patients of 9 months (range 1–21 months). There was a CR in 61 (93.8%) lesions. Three lesions (3.8%) had an initial PR and one (1.5%) had NR; all were re-treated to a dose of 8 Gy in 1 fraction. Three of these lesions went on to have a CR. Lesions that had a PR/NR were large (>14 cm) and involved the anterior thigh, posterior thigh, left buttock, and posterior neck. Tumor stage lesions responded equally well as plaque or patch lesions. Twelve of these lesions in three patients were those that were persistent after total skin electron therapy (TSET) to a dose of 36 Gy in 24 fractions. These lesions were in areas of skin folds and were treated 6–8 weeks after completion of TSET. CR was achieved in all these residual lesions with an additional single-fraction dose of 8 Gy. No treatment-related toxicity was observed in any of the patients.

Conclusion

Single-fraction radiation therapy is a highly effective palliative approach for treating limited extent CTCL lesions with minimal toxicity.

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