Does adjuvant alpha-interferon improve outcome when combined with total skin irradiation for mycosis fungoides?

Abstract

BACKGROUND:

Patients with mycosis fungoides (MF) experience frequent disease recurrences following total skin electron irradiation (TSEI) and may benefit from adjuvant therapy.

OBJECTIVES:

To review the McGill experience with adjuvant alpha-interferon (IFN) in the treatment of MF.

METHODS:

From 1990 to 2000, 50 patients with MF were treated with TSEI: 31 with TSEI alone and 19 with TSEI + IFN. Median TSEI dose was 35 Gy. In the TSEI + IFN group, IFN was given subcutaneously at 3 x 10(6) units three times per week starting 2 weeks prior to start of TSEI, continued concurrently with the radiation and for an additional 12 months following TSEI. The TSEI alone group included 16 men and 15 women with a median age of 61 years (range 31-84). The TSEI + IFN group included 14 men and five women with a median age of 51 years (range 24-83). Clinical stage was IA, IB, IIA, IIB, III and IVA in 2, 9, 4, 8, 1 and 7 patients of the TSEI group and 0, 3, 3, 7, 4 and 2 patients of the TSEI + IFN group.

RESULTS:

Median follow up for living patients was 70 months. All patients responded to treatment. Complete response (CR) rate was 65% following TSEI and 58% following TSEI + IFN (P = 0.6). Median overall survival (OS) was 61 months following TSEI and 38 months following TSEI + IFN (P = 0.4). Acute grade II-III dermatitis was seen in all patients. Fever, chills or myalgia were seen in 32% of patients treated with TSEI + IFN.

CONCLUSIONS:

Concurrent IFN and TSEI is feasible, with acceptable toxicity. Even when controlling for disease stage, the addition of IFN did not appear to increase CR rate, disease-free survival or OS.

• Authors: D Roberge, T Muanza, G Blake, C Shustik, T Vuong, C R Freeman
• Journal: The British journal of dermatology (Br J Dermatol) Vol. 156 Issue 1 Pg. 57-61 (Jan 2007) ISSN: 0007-0963 [Print] England
• PMID: 17199567 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Interferon Type I
• Recombinant Proteins

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Chemotherapy, Adjuvant (methods)
• Cohort Studies
• Combined Modality Therapy (methods)
• Disease-Free Survival
• Drug Eruptions (etiology)
• Female
• Humans
• Interferon Type I (therapeutic use)
• Male
• Middle Aged
• Mycosis Fungoides (drug therapy, radiotherapy)
• Neoplasm Recurrence, Local
• Recombinant Proteins
• Retrospective Studies
• Skin Neoplasms (drug therapy, radiotherapy)
• Treatment Outcome