Radiation Therapy

PCBCL are highly radiosensitive, and radiation therapy is often the preferred therapy for solitary or localized grouped lesions. There are few retrospective studies available on radiotherapy of PCBCL, and they include small numbers of patients. Prospective trials have not been reported. Reported complete remission rates range from 92 to 100%, with 5-year survival rates ranging from 67 to 100%.9-12 However, cutaneous recurrences are common, and were observed in 16-67% of patients.

In a recent retrospective study, 34 patients with PCBCL treated with radiotherapy were identified and classified according to EORTC and WHO criteria.9 Twenty-six patients were treated with electron beam radiation, six patients with orthovoltage radiation, and one patient each with photon beam radiation and combination of photon and electron beam radiation. The authors note that a 2- to 3-cm margin added to the radiation site is generally used at their institution, although exact data were not available. All patients achieved a complete response (CR) to initial treatment. Five-year relapse-free survival ranged from 62 to 73% for follicle center cell (FCC) by EORTC/diffuse large B-cell lymphoma (DLBCL) by WHO, FCC by EORTC/follicular lymphoma (Fol) by WHO, and MZL by EORTC and WHO, with a 5-year overall survival of 100%. Patients with LBCL of the leg by EORTC/leg DLBCL by WHO showed worse results, with a 5-year relapse-free survival of 33% and a 5-year overall survival of 67%. However, only three patients were classified as leg DLBCL. The less favorable prognosis of the anatomic site leg seems to be consistent with previously published data and EORTC classifica-tion.213 Eight of 13 relapses were confined to the skin and 5 developed extracutaneous spread. The

Table 59.1 The WHO-EORTC classification for primary cutaneous lymphomas and associated frequency and 5-year survival3

Cutaneous T-cell and NK-cell lymphoma

Indolent

Cutaneous T-cell and NK-cell lymphoma

Indolent

Mycosis fungoides

0 0

Post a comment