PMID- 31717353
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 11
IP  - 11
DP  - 2019 Nov 8
TI  - Lack of Durable Remission with Conventional-Dose Total Skin Electron Therapy for 
      the Management of Sezary Syndrome and Multiply Relapsed Mycosis Fungoides.
LID - 10.3390/cancers11111758 [doi]
LID - 1758
AB  - Mycosis fungoides (MF) and Sezary syndrome (SS) are multi-relapsing, morbid, 
      cutaneous T-cell lymphomas. Optimal treatment sequencing remains undefined. Total 
      skin electron therapy (TSE) is a highly technical, skin-directed treatment, 
      uniquely producing symptom-free and treatment-free intervals. Recent publications 
      favour low-dose TSE for reduced toxicity, but early data support 
      conventional-dose TSE (cdTSE) for longer disease control. Patient selection 
      requires weighing-up tolerability against response durability. We investigated 
      duration of benefit from cdTSE in patients with poorer prognosis diseases: SS and 
      heavily pre-treated MF. Endpoints were overall survival, and "time to next 
      treatment" (TTNT) as surrogate for clinical benefit duration. Seventy patients 
      (53 MF, 17 SS) were eligible: median prior treatments, 4; median cdTSE dose, 30 
      Gy; median follow-up, 5.8 years. SS patients had worse prognosis (HR = 5.0, p < 
      0.001) and shorter TTNT (HR = 4.5, p < 0.001) than MF patients; median TTNT was 
      only 3.7 months. Heavily pre-treated MF patients had inferior prognosis (HR = 
      1.19 per additional line, p = 0.005), and shorter TTNT (HR = 1.13 per additional 
      line, p = 0.031). Median TTNT for MF patients with >/=3 prior treatments was 7.1 
      months, versus 23.2 months for 0-2 prior treatments. In conclusion, cdTSE has a 
      limited role in SS. TTNT is reduced in heavily pre-treated MF patients, 
      suggesting greater benefit when utilized earlier in treatment sequencing.
FAU - Campbell, Belinda A
AU  - Campbell BA
AUID- ORCID: 0000-0002-7316-8723
AD  - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne 3000, 
      Victoria, Australia.
AD  - Department of Clinical Pathology, The University of Melbourne, Parkville 3010, 
      Victoria, Australia.
FAU - Ryan, Gail
AU  - Ryan G
AD  - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne 3000, 
      Victoria, Australia.
FAU - McCormack, Christopher
AU  - McCormack C
AD  - Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne 3000, 
      Victoria, Australia.
AD  - Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy 3065, 
      Victoria, Australia.
FAU - Tangas, Eleanor
AU  - Tangas E
AD  - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne 3000, 
      Victoria, Australia.
AD  - Melbourne Clinical School, School of Medicine, University of Notre Dame, Werribee 
      3030, Victoria, Australia.
FAU - Bressel, Mathias
AU  - Bressel M
AD  - Centre for Biostatics and Clinical Trials, Peter MacCallum Cancer Centre, 
      Melbourne 3000, Victoria, Australia.
FAU - Twigger, Robert
AU  - Twigger R
AD  - Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal 
      Melbourne Hospital, Melbourne 3000, Victoria, Australia.
FAU - Buelens, Odette
AU  - Buelens O
AD  - Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal 
      Melbourne Hospital, Melbourne 3000, Victoria, Australia.
FAU - van der Weyden, Carrie
AU  - van der Weyden C
AD  - Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal 
      Melbourne Hospital, Melbourne 3000, Victoria, Australia.
FAU - Prince, H Miles
AU  - Prince HM
AUID- ORCID: 0000-0002-0058-2448
AD  - Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal 
      Melbourne Hospital, Melbourne 3000, Victoria, Australia.
AD  - Sir Peter MacCallum Department of Oncology, The University of Melbourne, 
      Parkville 3010, Victoria, Australia.
LA  - eng
PT  - Journal Article
DEP - 20191108
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC6895845
OTO - NOTNLM
OT  - Sezary syndrome
OT  - cutaneous T-cell lymphoma
OT  - mycosis fungoides
OT  - skin-directed therapy
OT  - total skin electron therapy
COIS- The authors declare no conflict of interest.
EDAT- 2019/11/14 06:00
MHDA- 2019/11/14 06:01
PMCR- 2019/11/08
CRDT- 2019/11/14 06:00
PHST- 2019/09/22 00:00 [received]
PHST- 2019/10/31 00:00 [revised]
PHST- 2019/11/02 00:00 [accepted]
PHST- 2019/11/14 06:00 [entrez]
PHST- 2019/11/14 06:00 [pubmed]
PHST- 2019/11/14 06:01 [medline]
PHST- 2019/11/08 00:00 [pmc-release]
AID - cancers11111758 [pii]
AID - cancers-11-01758 [pii]
AID - 10.3390/cancers11111758 [doi]
PST - epublish
SO  - Cancers (Basel). 2019 Nov 8;11(11):1758. doi: 10.3390/cancers11111758.