Skin-directed radiation therapy for cutaneous lymphoma: The Mayo Clinic experience

Background: Focal or total skin radiation therapy can be used to treat 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 showed a 99% response rate and 80% complete response rate after treatment regardless of involvement, severity, histopathologic subtype, dose, or fractionation. The overall in-field recurrence rate was 15%, and median time to recurrence was 296 days (range, 1-1884 days). Focal and hypofractionated regimens were similarly associated with disease response and rare toxicity. Shortterm rates of secondary skin cancer after treatment were comparable to expected incidence in a patient population without radiation. Limitations: Large total number of treatments courses compared with 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.