ReportsTotal skin electron radiation in the management of mycosis fungoides: Consensus of the European Organization for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Project Group☆,☆☆,★,★★
Section snippets
Recommendations regarding TSEB technique
The principal objectives of any method of TSEB are listed in Table I.4• To align the distribution of dose to the target volume • To be practical, comfortable, and efficient for the patient • To provide sufficient dose within the target volume • To reliably attain cutaneous remission • To minimize toxicity • To produce beneficial long-term clinical results • To accommodate repeated administration as required
Minimizing toxicities, discomfort, and risks
Proper technique limits acute and chronic toxicities in incidence and severity and increases the therapeutic ratio. Tolerance depends on attention to schedule and fractionation,20 cointerventions, and judicious shielding of tissues exposed to relatively high doses.
Clinical indications
Clinical indications for TSEB are listed in Table III.
1. Patients with a new diagnosis of mycosis fungoides “Minimal” stage IA Not recommended (consider local radiation only) Stage IA & T1N1 A brief therapy with potential for long-term progression-free survival Stage IB & T2N1 As in stage IA, consider combination therapy (eg, with psoralen plus UV light) Stage IIB Effective palliation, consider combination therapy Stage III Potential for long-term
Conclusions
Most patients with MF can benefit from at least one course of TSEB at some time in their clinical course. Some patients experience long-standing remissions. Some appear to experience improved survival. In patients with advanced disease, effective palliation can be achieved with TSEB. The therapeutic ratio for TSEB compares well with ratios for other therapies. TSEB should be considered once a diagnosis of MF is established. It should be an option every time a therapeutic decision is to be made
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EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2023
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2021, Actas Dermo-SifiliograficasIn-vivo dosimetry in Total Skin Electron Therapy: Literature review
2021, Journal of Radiotherapy in Practice
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Funding sources: None.
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Conflict of interest: None.
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Reprint requests: Robert Knobler, MD, Department of Dermatology, Division of Special and Environmental Dermatology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
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Published online May 6, 2002.