Treatment of Mycosis Fungoides With Total Skin Electron Beam Response and Relapse by Ethnicity and Sex

Objective:To determine whether clinical response to total skin electron beam (TSEB) and relapse after TSEB differs by ethnicity and sex. Methods:Retrospective chart review of 77 patients with mycosis fungoides (MF), treated with TSEB in 2002 to 2008 at Yale University School of Medicine, Departments of Dermatology and Therapeutic Radiology. Results:Women had better odds of response to TSEB than men (OR=6.4; 95% CI, 1.45-28.5; P=0.01). No significant difference was observed in response to TSEB between white and black patients (OR=0.69; 95% CI, 0.16-2.91; P=0.62). When stratified by race and sex, in comparison with black females, all other groups had lower odds of complete response (CR) to TSEB: black males (OR=0.39; 95% CI, 0.002-0.70; P=0.03), white females (OR=0.24; 95% CI, 0.02-2.53; P=0.24), and white males (OR=0.06; 95% CI, 0.006-0.60; P=0.02). Clinical CR was significantly predicted by the duration of symptoms (OR=0.98; 95% CI, 0.97-0.99; P=0.01); and nearly significant by clinical stage; stage III to stage I (OR=0.17; 95% CI, 0.02-1.02; P=0.07). Adjuvant treatment, previous treatment, and time from diagnosis to treatment have no significant effect on CR to TSEB. There was no statistically significant association between relapse after treatment and race, sex, clinical stage, or symptom duration. Conclusions:The odds of achieving a CR to TSEB decrease when diagnosis of MF is delayed and when patients present with advanced-stage disease. Women with MF were more likely to have a CR to treatment, and this response was even more significant in black women.