A prospective cohort study of Condensed low dose total skin electron beam therapy for mycosis fungoides: reduction of disease burden and improvement in quality of life

Abstract Background Low-dose total skin electron beam therapy (TSEBT) for mycosis fungoides (MF) is popular due to reduced toxicity with effective palliation. We condensed TSEBT, reducing visits by half and overall treatment length by one-third. Objective To determine the efficacy and safety of a novel, condensed low-dose TSEBT for MF. Methods We conducted a cohort study (2014-2018), with median follow-up of 22.8 months. We delivered 12 Gy/6 fractions with modified Stanford technique, 3 fractions/week, boosts to shadowed sites at-risk interdigitated, completing in 2 weeks. Primary outcomes included clinical response, duration of and time to response, and toxicity. Secondary outcomes included patient-reported quality of life (QOL): pain, pruritus, and Dermatology Life Quality Index, and physician-scored disease burden: BSA involvement and Modified Skin Weighted Assessment Tool. Results Of 25 patients, Stage IB was most common at time of TSEBT (36%). Overall response rate was 88%. Most common was a near complete response (36%). Complete response was achieved in six (24%) patients. Median duration of response was 17.5 months (3.5-44.2) while median time to response 2 months (0.9-4.1). Zero Grade≥3 toxicity. QOL and disease burden showed significant benefit post-TSEBT (p Limitations Cohort study with limited sample size. Conclusions Condensed, low-dose TSEBT has favorable outcomes and toxicity with logistical convenience.