Radiotherapy in the treatment of primary cutaneous CD4 + small/medium T‐cell lymphoproliferative disorder

作者：Susan Wu, Ethan P. Damron, Jie Xu, Penny Fang, Julia Dai, Ranjit Nair, Luis Malpica, Luis Fayad, Carlos A. Torres‐Cabala, L. Jeffrey Medeiros, Francisco Vega, Roberto N. Miranda, Madeleine Duvic, Chelsea C. Pinnix, Bouthaina S. Dabaja, Swaminathan P. Iyer, Auris Huen, Jillian R. Gunther · 发表于：International Journal of Dermatology · 年份：2024 · DOI：10.1111/ijd.17352 · 被引用次数：5 · 研究领域：Cutaneous lymphoproliferative disorders research、Lymphoma Diagnosis and Treatment、Viral-associated cancers and disorders

BACKGROUND: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD) is an increasingly recognized entity with heterogeneous management strategies that may include radiotherapy. OBJECTIVE: Our aim was to characterize treatment options for PCSM-LPD, with a focus on the role of radiotherapy. METHODS: This is a retrospective review of 46 patients seen in the Cutaneous Lymphoma Program at the University of Texas MD Anderson Cancer Center, with a clinicopathologic review consistent with PCSM-LPD. All patients were biopsied and underwent observation, topical/intralesional steroids, and/or radiotherapy. Patients were confirmed to have residual disease prior to radiotherapy. RESULTS: All patients achieved a complete response (CR). Sixteen patients (35%) received focal radiotherapy, with a CR in 15 (94%). The CR rate following ultra-low-dose radiotherapy (4 Gy in 1-2 fractions) was 92%. There was no grade 3 toxicity after radiotherapy. Thirty patients were managed without radiotherapy, with excision and observation or steroids. CONCLUSION: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder has excellent outcomes, and management strategies may include observation following biopsy, steroids, or radiation. Ultra-low-dose radiotherapy results in excellent outcomes with limited toxicity and is effective for persistent lesions after steroidal therapy.