Potential of narrow-band ultraviolet B to induce sustained durable complete remission off-therapy in patients with stage I mycosis fungoides.

BACKGROUND

Narrow-band ultraviolet B (NB-UVB) is a first-line therapy for stage I mycosis fungoides (MF), with a complete response in 75%-85% of patients. However, data on long-term disease-free survival (DFS) after therapy are scarce.

OBJECTIVE

To assess the long-term DFS after NB-UVB treatment of stage I MF.

METHODS

We used a historic cohort of all stage I MF patients achieving a complete response with NB-UVB who discontinued treatment before 2011. Age at the beginning of phototherapy, sex, stage, skin phototype, number of treatments, total dose, and the length of DFS was collected.

RESULTS

Of the 117 patients who started NB-UVB, 93 patients (80%) had a complete response and 56 (60%) were disease free as of March 2017. In a multivariate analysis, DFS was affected independently by age and disease stage only. DFS was longer for patients <50 years old (124 months) than those ≥50 years old (91 months, P = .01) and longer for stage IA patients (131 months) than stage IB patients (87.6 months, P = .001).

LIMITATIONS: The study was retrospective in nature.

CONCLUSION

After a single course of NB-UVB, over a half of stage I MF patients achieved >5 years of DFS and were potentially cured. Thus, NB-UVB can be considered a disease-modifying therapy.