Hematologic Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_43_2734 - Condensed Low Dose Total Skin Electron Beam Therapy for Mycosis Fungoides: A Single Institution Experience

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Condensed Low Dose Total Skin Electron Beam Therapy for Mycosis Fungoides: A Single Institution Experience
A. J. Song1, A. Gochoco2, J. Sahu2, O. Alpdogan3, P. Porcu3, T. Zhan4, and W. Shi1; 1Dept of Radiation Oncology, Thomas Jefferson University Sidney Kimmel Cancer Center, Philadelphia, PA, 2Dept of Dermatology, Thomas Jefferson University, Philadelphia, PA, 3Dept of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, 4Dept of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA

Purpose/Objective(s): To determine safety and efficacy of condensed low dose total skin electron beam therapy (TSEBT), 12 Gy over two weeks, for mycosis fungoides (MF).

Materials/Methods: We conducted a retrospective review of patients treated with condensed low dose TSEBT for MF at our institution. Patients were treated with 6-field Stanford technique to a total dose of 12 Gy in 2 Gy fractions, every other day over 2 weeks. A total of 18 patients with minimum 6 months follow up were included. Treatment response rate was defined as complete response (CR), near CR (<5% body surface area [BSA]), and partial response (PR). Duration of response as measured from TSEBT start date to date of progression requiring systemic therapy or death. Pain, pruritus, Dermatology Life Quality Index (DLQI) score , DLQI effect, modified Severity Weighted Assessment Tool (mSWAT), BSA, and TSEBT-related toxicities were also evaluated. Statistical analysis was performed with R (version 3.4.3). Linear mixed models with random effect of patient was used for estimation of pre vs. post comparisons on efficacy endpoints. We evaluated with two-sample t-test, Fisher's exact test, as well as Cox proportional hazards model in addition to summary statistics of baseline characteristics.

Results: Of the 18 patients, 14 were male and 4 were female. Median follow-up of 63 weeks. Median age 69 yo (range 37-85). Majority were Stage IB (44%). Three patients had large cell transformation. Overall response rate was 100 percent. Complete response (CR) was seen in 3 patients (17%), and near CR in 7 patients (39%), and PR in 8 patients (44%). Median duration of response was 56 weeks, with seven patients (39%) having progression. Four patients died, of which one had large cell transformation. Treatment response metrics were all significantly reduced after TSEBT. Pruritus had a mean difference of 2.694 (95% CI 1.354, 4.035, p<0.001), pain of 2.694 (95% CI 1.021, 4.368, p=0.003), mSWAT of 57.53 (95% CI 32.08, 82.98, p<0.001), BSA of 32.88 (95% CI 18.86, 46.91, p<0.001), and DLQI of 6.56 (95% CI 3.55, 9.57, p<0.001). Treatment was well tolerated with no toxicity ≥ Grade 3. Most common toxicity was Grade 1 fatigue (33%) and Grade 1 alopecia (22%). Two patients experienced nail loss and three patients had Grade 2 radiation dermatitis that self-resolved.

Conclusion: Condensed low dose TSEBT shows excellent initial response with favorable duration of response, and effective palliation of symptoms. Further exploration with a prospective trial is warranted.

Author Disclosure: A.J. Song: None. A. Gochoco: None. J. Sahu: None. O. Alpdogan: None. P. Porcu: None. W. Shi: None.

Send Email for Andrew Song


Assets

MO_43_2734 - Condensed Low Dose Total Skin Electron Beam Therapy for Mycosis Fungoides: A Single Institution Experience



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Condensed Low Dose Total Skin Electron Beam Therapy for Mycosis Fungoides: A Single Institution Experience