The effect of phototherapy on progression to tumors in patients with patch and plaque stage of mycosis fungoides.

BACKGROUND

Phototherapy has been a mainstay in the treatment of mycosis fungoides (MF). However, the recent findings of UV-induced p53 mutations in advanced MF suggest that phototherapy may contribute to disease progression.

OBJECTIVE

The objective of this study was to evaluate the effect of phototherapy on the time to tumor progression and overall survival in MF.

MATERIALS AND

METHODS

Retrospective analysis of patients seen at the University of Pittsburgh Cutaneous Lymphoma Clinic from 1979 to 2016.

RESULTS

A total of 345 patients with MF were identified. 258 (74.8%) were diagnosed at stage IA or IB. 43 out of the 258 (16.6%) progressed to tumor stage. Before tumor development, 30 out of the 43 (69.8%) patients received phototherapy, and 13 (30.2%) did not. Patients who received phototherapy had a longer median time to tumor progression than those who did not: 3.5 years (interquartile range = 1.9-5.7) versus 1.2 years (0.2-2.3) (p = .001). Patients who received phototherapy also survived longer: 6.9 years (interquartile range = 4.3-9.5) versus 3.8 years (3.0-4.5) (p = .014).

LIMITATIONS: Limited information on specific phototherapy start dates, durations, and treatment protocols.

CONCLUSIONS

The therapeutic effects of phototherapy, with longer times to tumor progression and increased overall survival, appear to outweigh its potential adverse effects.