Reduced-Dose Total Skin Electron Beam Radiation Therapy in Mycosis Fungoides and Sézary Syndrome: Systematic Review and Meta-Analysis
Abstract
Purpose: Primary cutaneous T-cell lymphomas are a heterogeneous group of T-cell neoplastic entities associated with significant morbidity and high radiosensitivity. Although research on reduced-dose radiation treatment for mycosis fungoides and Sézary syndrome has significantly increased over the past 2 decades, randomized data are lacking. We aim to summarize the available evidence and analyze the safety and efficacy of reduced-dose total skin electron beam therapy (TSEBT).
Methods and materials: A literature search for evidence was conducted, selecting studies with reduced-dose TSEBT in mycosis fungoides and Sézary syndrome that met the inclusion criteria. The studies were critically appraised, and the results were synthesized and interpreted.
Results: The analyzed data comprised 11 prospective studies and 11 retrospective studies, with a total of 883 patients. The meta-analysis revealed a pooled overall response rate of 91% (95% CI, 88-93) and complete response rate of 26% (95% CI, 21-31) to reduced-dose TSEBT. The most common toxicities reported were grade 1 and 2 skin reactions. Documented in 7 studies, the time to response ranged from 4 to 8 weeks. Seven studies evaluated the impact of reduced-dose TSEBT on quality of life, and all reported significant improvements in 1 or more subdomains. Fourteen studies indicated that 337 patients (38%) received consolidation/subsequent therapy after TSEBT to maintain remission. Compared with TSEBT monotherapy, the addition of…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 883 participants or records.
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