Radiotherapy Eradicates Malignant T Cells and Is Associated with Improved Survival in Early-Stage Mycosis Fungoides
| Autor: | Rachael A. Clark, Jessica E. Teague, Anita Giobbie-Hurder, John T. O'Malley, Adèle de Masson, A. Gehad, Nicole R. LeBoeuf, Thomas S. Kupper, E.L. Lowry, Cecilia Larocca, Edward W Seger, David C. Fisher, Phillip M. Devlin |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research medicine.medical_specialty Skin Neoplasms Adolescent medicine.medical_treatment Clone (cell biology) Gastroenterology Article Lesion Young Adult 03 medical and health sciences Mycosis Fungoides 0302 clinical medicine T-Lymphocyte Subsets Internal medicine Biomarkers Tumor Humans Medicine Prospective Studies Stage (cooking) Prospective cohort study Survival rate Aged Retrospective Studies Aged 80 and over Mycosis fungoides Radiotherapy business.industry Receptors Antigen T-Cell gamma-delta Middle Aged medicine.disease Lymphoma T-Cell Cutaneous Lymphoma Survival Rate Radiation therapy Treatment Outcome 030104 developmental biology Oncology 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local medicine.symptom business |
| Zdroj: | Clin Cancer Res |
| ISSN: | 1557-3265 1078-0432 |
| Popis: | Purpose: Mycosis fungoides is the most common subtype of cutaneous T-cell lymphoma. Skin-directed treatments often improve but do not cure mycosis fungoides skin lesions. The purpose of this study was to (i) assess whether remission was associated with malignant T-cell clone depletion at treated sites using either low-dose radiotherapy (LDRT, 8 Gy) or topical steroids and (ii) assess whether a clone-ablative therapy, like LDRT, is associated with overall survival in patients with high-risk early-stage CTCL. Experimental Design: Pre- and posttreatment biopsies from 20 lesional skin samples of 18 patients with mycosis fungoides who received either 8 Gy LDRT (n = 16) or topical steroids (n = 4) underwent high-throughput T-cell receptor sequencing of the TCRB gene to quantify the malignant T-cell clone. For the retrospective chart review, overall survival of 47 high-risk early-stage patients was compared between patients who did or did not receive radiation. Results: LDRT eradicated the clone in 5 of 16 lesions and reduced it >90% in 11 of 16; there were no recurrences in these lesions. Patients treated with topical steroids appeared to clinically improve, but the malignant clone persisted. We found that the number of residual malignant T cells predicted lesion recurrence. A retrospective review showed that early-stage high-risk patients who received radiation as part of their treatment regimen had prolonged overall survival compared with patients who did not. Conclusions: These findings demonstrate that LDRT can eradicate malignant T cells in mycosis fungoides, provides robust disease control, and is associated with improved survival in high-risk early-stage patients. |
| Databáze: | OpenAIRE |
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