Skin Directed Radiation Therapy for Cutaneous Lymphoma: The Mayo Clinic Experience

Abstract Background Focal or total skin radiation therapy can be employed as treatment of mild to refractory cutaneous T-cell lymphoma. Objective To report the broad therapeutic benefit of radiation therapy for cutaneous T-cell lymphoma. Methods Retrospective single institution review of outcomes for skin-directed radiation therapy. Results Skin-directed radiation therapy demonstrated 99% response rate and 80% complete response rate after treatment regardless of involvement, severity, histopathologic subtype, dose, or fractionation. Overall in-field recurrence rate was 15%; median time to recurrence was 296 days (range, 1-1884). Focal and hypofractionated regimens were similarly associated with disease response and rare toxicity. Short term rates of secondary skin cancer after treatment were comparable to expected incidence in a non-irradiated patient population. Limitations Large total number of treatments courses compared to the overall number of patients. Heterogenous mix of treatment regimens (no standardization of dose or fraction number). Conclusions Radiation therapy is a well-tolerated treatment option for properly selected patients with cutaneous T-cell lymphoma.