Management of Lymphoma Cutis with Low Megavolt Electron Beam Therapy

Fromer, John L.; Johnston, David; Salzman, Ferdinand A.; Trump, John G.; Wright, K. A.

doi:10.1097/00007611-196107000-00013

Cited by 27 publications

(4 citation statements)

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“…Thus toxicity to internal organs including the bone marrow is largely avoided. The technique has a long history in the treatment of cutaneous lymphomas and already in 1961 a nine-year follow up of 200 patients was reported [46]. Since then, not only radiation technology has advanced but also clinical experience from large centres has helped to refine the method to provide a sufficiently distributed dose to the target volume to reliably induce remission with acceptable toxicity.…”

Section: Total Skin Electron Beam Therapymentioning

confidence: 99%

European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2017

Trautinger

Eder

Assaf

et al. 2017

European Journal of Cancer

426

492

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In order to provide a common standard for the treatment of mycosis fungoides (MF) and Sézary syndrome (SS), the European Organisation for Research and Treatment of Cancer-Cutaneous Lymphoma Task Force (EORTC-CLTF) published in 2006 its consensus recommendations for the stage-adapted selection of management options for these neoplasms. Since then, the understanding of the pathophysiology and epidemiology of MF/SS has advanced, the staging system has been revised, new outcome data have been published and novel treatment options have been introduced. The purpose of the present document is to update the original recommendations bearing in mind that there are still only a limited number of controlled studies to support treatment decisions for MF/SS and that often treatment is determined by institutional experience and availability. This consensus on treatment recommendations was established among the authors through a series of consecutive consultations in writing and a round of discussion. Recommended treatment options are presented according to disease stage, whenever possible categorised into first- and second-line options and supported with levels of evidence as devised by the Oxford Centre for Evidence-Based Medicine (OCEBM). Skin-directed therapies are still the most appropriate option for early-stage MF, and most patients can look forward to a normal life expectancy. For patients with advanced disease, prognosis is still grim, and only for a highly selected subset of patients, prolonged survival can be achieved with allogeneic stem cell transplantation (alloSCT). There is a high need for the development and investigation in controlled clinical trials of treatment options that are based on our increasing understanding of the molecular pathology of MF/SS.

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Section: Total Skin Electron Beam Therapymentioning

confidence: 99%

European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2017

Trautinger

Eder

Assaf

et al. 2017

European Journal of Cancer

426

492

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“…Due to the limited penetrability of the radiation used, response in the tumor stage is less satisfactory, particularly when markedly elevated tumors are present. In the presence of large tumors total‐body electron‐beam therapy yields better results because of deeper penetration,,,. Residual tumors following teleroentgen therapy may also be treated with additional superficial X‐ray therapy to individual lesions to the point of their disappearance.…”

Section: Indicationsmentioning

confidence: 99%

“…Teleroentgen therapy was described by Schirren over 20 years ago when only two electron‐beam units were available in the United States. The method has a great advantage in that any X‐ray machine with a beryllium window operable at 50 to 100 kV can easily be converted for treatment of cutaneous lymphomas.…”

mentioning

confidence: 99%

Teleroentgen Therapy for Mycosis Fungoides

Goldschmidt¹,

Lukacs²,

Schoefinius³

1978

The Journal of Dermatologic Surgery and Oncology

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“…A number of treatments are available, but none induces long‐term remission, and treatment is therefore often regarded as palliative despite long survival. Mycosis fungoides has been treated with radiotherapy since the 1960s, and Total Skin Electron Beam Therapy (TSEBT) is considered the standard treatment today . Traditionally, a prescribed dose of 30–36 Gy over 6–10 weeks has been recommended, but recently, doses as low as 10–12 Gy have been used for step‐wise short‐term palliation .…”

Section: Introductionmentioning

confidence: 99%

A Helical tomotherapy as a robust low‐dose treatment alternative for total skin irradiation

Haraldsson

Engleson

Bäck

et al. 2019

J Applied Clin Med Phys

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Mycosis fungoides is a disease with manifestation of the skin that has traditionally been treated with electron therapy. In this paper, we present a method of treating the entire skin with megavoltage photons using helical tomotherapy (HT), verified through a phantom study and clinical dosimetric data from our first two treated patients. A whole body phantom was fitted with a wetsuit as bolus, and scanned with computer tomography. We accounted for variations in daily setup using virtual bolus in the treatment plan optimization. Positioning robustness was tested by moving the phantom, and recalculating the dose at different positions. Patient treatments were verified with in vivo film dosimetry and dose reconstruction from daily imaging. Reconstruction of the actual delivered dose to the patients showed similar target dose as the robustness test of the phantom shifted 10 mm in all directions, indicating an appropriate approximation of the anticipated setup variation. In vivo film measurements agreed well with the calculated dose confirming the choice of both virtual and physical bolus parameters. Despite the complexity of the treatment, HT was shown to be a robust and feasible technique for total skin irradiation. We believe that this technique can provide a viable option for Tomotherapy centers without electron beam capability.

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Management of Lymphoma Cutis with Low Megavolt Electron Beam Therapy

Cited by 27 publications

References 0 publications

European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2017

European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2017

Teleroentgen Therapy for Mycosis Fungoides

A Helical tomotherapy as a robust low‐dose treatment alternative for total skin irradiation

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