Abstract

Apart from systemic or nodal lymphomas, cutaneous lymphomas present a heterogeneous group of relatively infrequent non-Hodgkin lymphomas with distinct clinical characteristics. Among cutaneous lymphomas, primary cutaneous T cell lymphomas account for the majority of cases with Mycosis Fungoides (MF) being the most prevalent subtype. Skin-directed treatment constitutes the principal mode of management for early stage MF, and systemic therapies or combination of modalities are typically employed in more advanced stages. Radiation therapy including Total Skin Electron Beam Therapy (TSEBT) is a viable skin-directed tratment modality in the management of patients suffering from MF. Radiotherapy may be used alone or as part of multidisciplinary management with excellent complete response rates. Total skin irradiation is a sophisticated procedure which may be performed using different techniques such as rotational techniques, large electron field techniques, and translational techniques. Prospective randomized comparisons of different therapeutic options in the management of different stages of MF are lacking partly due to its rarity. Nevertheless, radiotherapy may be particularly effective in eradication of cutaneous tumors or thick plaques with its deep penetration capability. While radiation therapy offers the potential for cure in selected patients with unilesional disease, it may also be used for improving local control and palliating symptoms in advanced stages of MF. Radiotherapy doses of ≥ 30 Gy have been used for a long time period considering a dose-response relationship, however, there is a trend towards the use of lower doses recently since many patients may eventually need reirradiation in the course of their disease. MF is considered to be highly radiosensitive, and encouraging treatment results have been achieved with even low doses of radiation. Herein, we present a concise review of the literature regarding the use of radiotherapy in MF management.

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