Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group

Rutger C. Melchers; Rein Willemze; Laurien A. Daniels; Karen J. Neelis; Marcel W. Bekkenk; Ellen R. M. de Haas; Barbara Horvath; Michelle M. van Rossum; Cornelus J. G. Sanders; Berit Velstra; Joep C. J. M. Veraart; Rachel E. J. Roach; Maarten H. Vermeer; Koen D. Quint

doi:10.1016/j.ijrobp.2017.08.010

Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group

Rutger C. Melchers^*, Rein Willemze, Laurien A. Daniels, Karen J. Neelis, Marcel W. Bekkenk, Ellen R. M. de Haas, Barbara Horvath, Michelle M. van Rossum, Cornelus J. G. Sanders, Berit Velstra, Joep C. J. M. Veraart, Rachel E. J. Roach, Maarten H. Vermeer, Koen D. Quint

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Purpose: To determine the optimal radiation dose for treatment of primary cutaneous anaplastic large cell lymphoma (C-ALCL) with solitary or localized, multifocal or recurrent skin lesions.

Methods and Materials: In this multicenter study, patients with C-ALCL who had been treated with radiation therapy (RT) between 1984 and 2016 were retrieved from the Dutch registry of cutaneous lymphomas. Distinction was made between patients first presenting with solitary or localized lesions (n=63), with multifocal skin lesions (n=6), and patients with a skin relapse (n=22). Radiation doses, treatment response, and follow-up were evaluated. Radiation doses were categorized as low-dose (

Results: Of 63 patients presenting with solitary or localized skin lesions, 61 (97%) showed a complete response (CR). There were no differences in CR between lowdose (16 of 17), intermediate-dose (15 of 15), and high-dose RT (30 of 31). After a median follow-up of 46 months, 30 of 63 patients (48%) had a relapse, but in-field relapses were never observed. Six of 6 patients (100%) initially presenting with multifocal skin lesions showed a CR (3 of 3 low-dose, 2 of 2 intermediate-dose, 1 of 1 high-dose RT). After a median follow-up of 27 months, 3 of 6 patients had a relapse. Treatment of 33 skin relapses in 22 patients showed no differences in CR between low-dose (18 of 19), intermediate-dose (6 of 6), and high-dose RT (8 of 8). In the last 10 years there has been a decrease in radiation dose used in the treatment of C-ALCL. Treatment of multifocal and recurrent lesions with a dose of 8 Gy (2 x 4 Gy) resulted in CR of 17 of 18 lesions.

Conclusions: Our results show that a radiation dose of 20 Gy (8 x 2.5 Gy) is effective in patients presenting with solitary or localized skin lesions. For patients with multifocal skin lesions and patients with a skin relapse, a dose of 8 Gy (2 x 4 Gy) may be sufficient. (C) 2017 Elsevier Inc. All rights reserved.

Original language	English
Pages (from-to)	1279-1285
Number of pages	7
Journal	International Journal of Radiation Oncology Biology Physics
Volume	99
Issue number	5
DOIs	https://doi.org/10.1016/j.ijrobp.2017.08.010
Publication status	Published - 1 Dec 2017

Keywords

CD30(+) LYMPHOPROLIFERATIVE DISORDERS
ONCOLOGY GROUP
EXPERIENCE
THERAPY
EORTC
CLASSIFICATION
GUIDELINES
PAPULOSIS
ISCL

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Melchers, R. C., Willemze, R., Daniels, L. A., Neelis, K. J., Bekkenk, M. W., de Haas, E. R. M., Horvath, B., van Rossum, M. M., Sanders, C. J. G., Velstra, B., Veraart, J. C. J. M., Roach, R. E. J., Vermeer, M. H., & Quint, K. D. (2017). Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group. International Journal of Radiation Oncology Biology Physics, 99(5), 1279-1285. https://doi.org/10.1016/j.ijrobp.2017.08.010

@article{27fc96e0c28248289b84fdbd11d628e4,

title = "Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group",

abstract = "Purpose: To determine the optimal radiation dose for treatment of primary cutaneous anaplastic large cell lymphoma (C-ALCL) with solitary or localized, multifocal or recurrent skin lesions.Methods and Materials: In this multicenter study, patients with C-ALCL who had been treated with radiation therapy (RT) between 1984 and 2016 were retrieved from the Dutch registry of cutaneous lymphomas. Distinction was made between patients first presenting with solitary or localized lesions (n=63), with multifocal skin lesions (n=6), and patients with a skin relapse (n=22). Radiation doses, treatment response, and follow-up were evaluated. Radiation doses were categorized as low-dose (Results: Of 63 patients presenting with solitary or localized skin lesions, 61 (97%) showed a complete response (CR). There were no differences in CR between lowdose (16 of 17), intermediate-dose (15 of 15), and high-dose RT (30 of 31). After a median follow-up of 46 months, 30 of 63 patients (48%) had a relapse, but in-field relapses were never observed. Six of 6 patients (100%) initially presenting with multifocal skin lesions showed a CR (3 of 3 low-dose, 2 of 2 intermediate-dose, 1 of 1 high-dose RT). After a median follow-up of 27 months, 3 of 6 patients had a relapse. Treatment of 33 skin relapses in 22 patients showed no differences in CR between low-dose (18 of 19), intermediate-dose (6 of 6), and high-dose RT (8 of 8). In the last 10 years there has been a decrease in radiation dose used in the treatment of C-ALCL. Treatment of multifocal and recurrent lesions with a dose of 8 Gy (2 x 4 Gy) resulted in CR of 17 of 18 lesions.Conclusions: Our results show that a radiation dose of 20 Gy (8 x 2.5 Gy) is effective in patients presenting with solitary or localized skin lesions. For patients with multifocal skin lesions and patients with a skin relapse, a dose of 8 Gy (2 x 4 Gy) may be sufficient. (C) 2017 Elsevier Inc. All rights reserved.",

keywords = "CD30(+) LYMPHOPROLIFERATIVE DISORDERS, ONCOLOGY GROUP, EXPERIENCE, THERAPY, EORTC, CLASSIFICATION, GUIDELINES, PAPULOSIS, ISCL",

author = "Melchers, {Rutger C.} and Rein Willemze and Daniels, {Laurien A.} and Neelis, {Karen J.} and Bekkenk, {Marcel W.} and {de Haas}, {Ellen R. M.} and Barbara Horvath and {van Rossum}, {Michelle M.} and Sanders, {Cornelus J. G.} and Berit Velstra and Veraart, {Joep C. J. M.} and Roach, {Rachel E. J.} and Vermeer, {Maarten H.} and Quint, {Koen D.}",

year = "2017",

month = dec,

day = "1",

doi = "10.1016/j.ijrobp.2017.08.010",

language = "English",

volume = "99",

pages = "1279--1285",

journal = "International Journal of Radiation Oncology Biology Physics",

issn = "0360-3016",

publisher = "Elsevier Science",

number = "5",

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Melchers, RC, Willemze, R, Daniels, LA, Neelis, KJ, Bekkenk, MW, de Haas, ERM, Horvath, B, van Rossum, MM, Sanders, CJG, Velstra, B, Veraart, JCJM, Roach, REJ, Vermeer, MH & Quint, KD 2017, 'Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group', International Journal of Radiation Oncology Biology Physics, vol. 99, no. 5, pp. 1279-1285. https://doi.org/10.1016/j.ijrobp.2017.08.010

Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group. / Melchers, Rutger C.; Willemze, Rein; Daniels, Laurien A. et al.
In: International Journal of Radiation Oncology Biology Physics, Vol. 99, No. 5, 01.12.2017, p. 1279-1285.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma

T2 - A Report of the Dutch Cutaneous Lymphoma Group

AU - Melchers, Rutger C.

AU - Willemze, Rein

AU - Daniels, Laurien A.

AU - Neelis, Karen J.

AU - Bekkenk, Marcel W.

AU - de Haas, Ellen R. M.

AU - Horvath, Barbara

AU - van Rossum, Michelle M.

AU - Sanders, Cornelus J. G.

AU - Velstra, Berit

AU - Veraart, Joep C. J. M.

AU - Roach, Rachel E. J.

AU - Vermeer, Maarten H.

AU - Quint, Koen D.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Purpose: To determine the optimal radiation dose for treatment of primary cutaneous anaplastic large cell lymphoma (C-ALCL) with solitary or localized, multifocal or recurrent skin lesions.Methods and Materials: In this multicenter study, patients with C-ALCL who had been treated with radiation therapy (RT) between 1984 and 2016 were retrieved from the Dutch registry of cutaneous lymphomas. Distinction was made between patients first presenting with solitary or localized lesions (n=63), with multifocal skin lesions (n=6), and patients with a skin relapse (n=22). Radiation doses, treatment response, and follow-up were evaluated. Radiation doses were categorized as low-dose (Results: Of 63 patients presenting with solitary or localized skin lesions, 61 (97%) showed a complete response (CR). There were no differences in CR between lowdose (16 of 17), intermediate-dose (15 of 15), and high-dose RT (30 of 31). After a median follow-up of 46 months, 30 of 63 patients (48%) had a relapse, but in-field relapses were never observed. Six of 6 patients (100%) initially presenting with multifocal skin lesions showed a CR (3 of 3 low-dose, 2 of 2 intermediate-dose, 1 of 1 high-dose RT). After a median follow-up of 27 months, 3 of 6 patients had a relapse. Treatment of 33 skin relapses in 22 patients showed no differences in CR between low-dose (18 of 19), intermediate-dose (6 of 6), and high-dose RT (8 of 8). In the last 10 years there has been a decrease in radiation dose used in the treatment of C-ALCL. Treatment of multifocal and recurrent lesions with a dose of 8 Gy (2 x 4 Gy) resulted in CR of 17 of 18 lesions.Conclusions: Our results show that a radiation dose of 20 Gy (8 x 2.5 Gy) is effective in patients presenting with solitary or localized skin lesions. For patients with multifocal skin lesions and patients with a skin relapse, a dose of 8 Gy (2 x 4 Gy) may be sufficient. (C) 2017 Elsevier Inc. All rights reserved.

AB - Purpose: To determine the optimal radiation dose for treatment of primary cutaneous anaplastic large cell lymphoma (C-ALCL) with solitary or localized, multifocal or recurrent skin lesions.Methods and Materials: In this multicenter study, patients with C-ALCL who had been treated with radiation therapy (RT) between 1984 and 2016 were retrieved from the Dutch registry of cutaneous lymphomas. Distinction was made between patients first presenting with solitary or localized lesions (n=63), with multifocal skin lesions (n=6), and patients with a skin relapse (n=22). Radiation doses, treatment response, and follow-up were evaluated. Radiation doses were categorized as low-dose (Results: Of 63 patients presenting with solitary or localized skin lesions, 61 (97%) showed a complete response (CR). There were no differences in CR between lowdose (16 of 17), intermediate-dose (15 of 15), and high-dose RT (30 of 31). After a median follow-up of 46 months, 30 of 63 patients (48%) had a relapse, but in-field relapses were never observed. Six of 6 patients (100%) initially presenting with multifocal skin lesions showed a CR (3 of 3 low-dose, 2 of 2 intermediate-dose, 1 of 1 high-dose RT). After a median follow-up of 27 months, 3 of 6 patients had a relapse. Treatment of 33 skin relapses in 22 patients showed no differences in CR between low-dose (18 of 19), intermediate-dose (6 of 6), and high-dose RT (8 of 8). In the last 10 years there has been a decrease in radiation dose used in the treatment of C-ALCL. Treatment of multifocal and recurrent lesions with a dose of 8 Gy (2 x 4 Gy) resulted in CR of 17 of 18 lesions.Conclusions: Our results show that a radiation dose of 20 Gy (8 x 2.5 Gy) is effective in patients presenting with solitary or localized skin lesions. For patients with multifocal skin lesions and patients with a skin relapse, a dose of 8 Gy (2 x 4 Gy) may be sufficient. (C) 2017 Elsevier Inc. All rights reserved.

KW - CD30(+) LYMPHOPROLIFERATIVE DISORDERS

KW - ONCOLOGY GROUP

KW - EXPERIENCE

KW - THERAPY

KW - EORTC

KW - CLASSIFICATION

KW - GUIDELINES

KW - PAPULOSIS

KW - ISCL

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DO - 10.1016/j.ijrobp.2017.08.010

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