Acute toxicity and risk of infection during total skin electron beam therapy for mycosis fungoides

J Am Acad Dermatol. 2013 Oct;69(4):537-43. doi: 10.1016/j.jaad.2013.04.063. Epub 2013 Jul 9.

Abstract

Background: Detailed rates of acute toxicity and skin infection during total skin electron beam therapy (TSEBT) for mycosis fungoides have not been reported in a large, modern series.

Objective: We sought to demonstrate the rates of acute toxicity and skin infection during TSEBT.

Methods: We retrospectively reviewed 89 consecutive courses of TSEBT. In all, 82 courses were prescribed a dose of 30 to 36 Gy and were included in the toxicity analysis. We recorded the types and grades of acute treatment toxicities and the incidence of infection during TSEBT for comparison with the previously documented baseline incidence of infection in mycosis fungoides.

Results: The most common toxicities included erythema/desquamation (76%), blisters (52%), hyperpigmentation (50%), and skin pain (48%). The worst reported toxicity grade per patient was grade 1 in 21%, grade 2 in 67%, and grade 3 in 10%, with no grade 4 or 5 toxicities. According to the previously reported rate, a total of 2.4 infections were expected for our cohort at baseline. The number with skin infection was 26 (32%) (relative risk 10.8, P < .01), and of these, 12 (15%) were culture confirmed (relative risk 5.0, P < .01).

Limitations: This was a retrospective study design.

Conclusion: The risk of cutaneous infection is significant during TSEBT.

Keywords: AJCC; American Joint Committee on Cancer; ECP; MF; OR; RT; TSEBT; extracorporeal photopheresis; infection; mycosis fungoides; odds ratio; race; radiation therapy; total skin electron beam therapy; toxicity.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adult
  • Age Factors
  • Aged
  • Analysis of Variance
  • Cohort Studies
  • Dermatomycoses / epidemiology
  • Dermatomycoses / etiology*
  • Dermatomycoses / physiopathology
  • Dose Fractionation, Radiation
  • Dose-Response Relationship, Radiation
  • Electrons
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Mycosis Fungoides / mortality
  • Mycosis Fungoides / pathology
  • Mycosis Fungoides / radiotherapy*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Radiodermatitis / diagnosis
  • Radiodermatitis / epidemiology*
  • Radiotherapy Dosage
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Skin Diseases, Bacterial / epidemiology
  • Skin Diseases, Bacterial / etiology*
  • Skin Diseases, Bacterial / physiopathology
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology
  • Skin Neoplasms / radiotherapy*
  • Whole-Body Irradiation / adverse effects*