Novel electron beam therapy approach yields swift response in T-cell lymphoma lesions

A novel technique of low-dose rotational total skin electron beam therapy provided a fast and durable response in a small cohort of patients with skin lesions associated with cutaneous T-cell lymphoma.

Neil B. Newman, MD, MS, of the department of radiation oncology at Vanderbilt University Medical Center, and colleagues conducted the prospective clinical trial of 20 patients who initially completed the Skindex-29 quality of life survey and had the Modified Severity-Weighted Assessment Tool score recorded at baseline.

The treatment regimen consisted of 12 Gy in 12 fractions with a novel dual-field rotational technique. Overall response rate served as the primary outcome measure. Time to treatment response, duration of clinical benefit and quality of life change served as key secondary outcomes.

Results showed an overall response rate of 90%. Only two patients failed to experience a reduction of at least 50% from baseline.

Treatment responses were observed at a median of 6.5 weeks. The researchers also observed time to patient-reported response, which occurred at 3.5 weeks.

Baseline data showed Modified Severity-Weighted Assessment Tool score of 55.6. At final follow-up, this score was reduced to a median of 2.2 (P < .001). The lowest median reported score in this parameter was 1.13. Moreover, 55% of the cohort experienced at least a 97% decrease in this score compared with baseline.

A median duration of clinical benefit of 21 months was observed.

Over time, total Skindex-29 score declined, as did every subdomain, at each consecutive clinical visit (P = .004).

“Our study adds to the increasing body of literature suggesting low-dose total skin electron beam therapy regimens may be the preferred initial treatment strategy for patients with widespread skin manifestations of mycosis fungoides,” the researchers wrote.