Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides.

Abstract

INTRODUCTION:

Mycosis fungoides (MF) is a non-Hodgkin's T-cell lymphoma of the skin that often begins as limited patches and plaques with slow progression to systemic involvement. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short-term treatment modality for clearing patch-stage MF. The effect of psoralen plus long-wave ultraviolet A (PUVA) in the treatment of patch- and plaque-type MF has also been thoroughly documented.

OBJECTIVES:

The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early-stage MF.

METHODS:

We analysed the response to treatment, relapse-free survival and irradiation dose in 114 patients with histologically confirmed early-stage MF (stage IA, IB and IIA).

RESULTS:

A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient. There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment.

CONCLUSIONS:

Our results confirm that phototherapy is a safe, effective and well-tolerated, first-line therapy in patients with early-stage cutaneous T-cell lymphoma, with prolonged disease-free remissions being achieved. It suggests that narrowband UVB is at least as effective as PUVA for treatment of early-stage MF.

• Authors: P Ponte, V Serrão, M Apetato
• Journal: Journal of the European Academy of Dermatology and Venereology : JEADV (J Eur Acad Dermatol Venereol) Vol. 24 Issue 6 Pg. 716-21 (Jun 2010) ISSN: 1468-3083 [Electronic] England
• PMID: 19929938 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Dose-Response Relationship, Radiation
• Female
• Humans
• Kaplan-Meier Estimate
• Lymphoma, T-Cell, Cutaneous (drug therapy, radiotherapy)
• Male
• Middle Aged
• Mycosis Fungoides (drug therapy, radiotherapy)
• Neoplasm Staging
• PUVA Therapy (adverse effects)
• Retrospective Studies
• Skin Neoplasms (drug therapy, radiotherapy)
• Treatment Outcome
• Ultraviolet Therapy (adverse effects)