Evaluation and recommendations for therapy of advanced mycosis fungoides lymphoma

Between 1 January 1975 and 1 October 1977, 30 patients with biopsy proven mycosis fungoides lymphoma were treated to the total skin suface uilizing 3.8 MeV electrons. Only 8/30 (27%) had early disease and 22/30 (73%) had late disease. All but 4 patients had been unresponsive to previous topical therapy or were unable to tolerate continued topical therapy because of skin sensitivity. Of 28 patients eligible for examination, 16 (57%) either failed to demonstrate complete disease clearance or, if initial clearance occurred, they had recurrent disease within 3 months. An additional 3 patients recurred within 4 to 6 months. Results suggest that electron beam irradiation alone is unable to induce and maintain clearance of disease in patients with advanced involvement or in those who have failed on previous topical therapy. Treatment failure may be related to development of a relatively resistant cell line (26/30 patients had failed on previous therapy) or to the therapeutic and prognostic implications of cutaneous tumors or extra-cutaneous disease