Radiation Therapy and Malignant T-Cell Levels in Early-Stage Mycosis Fungoides
Posted: Tuesday, January 21, 2020
Low-dose radiation therapy appears to eradicate malignant T cells in some patients with mycosis fungoides, according to research by John T. O’Malley, MD, PhD, of Dana-Farber Cancer Institute and Brigham and Women’s Cancer Center, Boston, and colleagues. The study, published in Clinical Cancer Research, also found that radiation therapy improved survival in patients with high-risk early-stage disease.
A total of 20 lesional skin sites from 18 patients with mycosis fungoides were biopsied before and after treatment with either low-dose (8 Gy) radiation therapy (n = 16) or topical steroids (n = 4). High-throughput T-cell receptor sequencing of the TCRB gene measured levels of the malignant T cells in the lesion samples.
Low-dose radiation therapy eradicated malignant T cells in 5 of 16 lesions and reduced levels by more than 90% in the remaining 11 lesions. Patients treated with topical steroids appeared to have clinical improvement, but levels of the malignant T-cell clone were not reduced. The researchers discovered that the number of residual malignant T cells was a predictor of lesion recurrence.
Dr. O’Malley and colleagues also completed a retrospective chart review of 47 patients with high-risk, early-stage mycosis fungoides. They found that patients who received radiation as part of their treatment regimen had prolonged overall survival compared with patients who did not receive radiation.
Disclosure: For full disclosures of the study authors, visit clincancerres.aacrjournals.org.