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Phototherapy for early-stage mycosis fungoides |
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Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Phototherapy for early-stage mycosis fungoides. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication Dates. 2012 Authors' conclusions Cutaneous T-cell lymphomas (CTCL) are a heterogeneous group of non-Hodgkin's lymphomas characterized by their initial manifestation in the skin. Mycosis fungoides (MF), which evolves from scaly skin patches and plaques, is the most common form of CTCL affecting approximately 65% of cases. The incidence of MF in the United States has been estimated at 6 cases per 1 million individuals with a male predominance. MF is broadly divided into early- and advanced-stage disease and classified into four clinical stages (I-IV). Skin patches and plaques occur in stage I, which is divided into IA (< 10% body surface area [BSA]) or IB ( 10% BSA). The presence of clinically evident lymphadenopathy without pathologic nodal infiltration represents stage IIA, cutaneous tumors characterize stage IIB, generalized erythroderma characterizes stage III, pathologically positive lymph nodes (IVA), and visceral disease characterizes stage IVB. Patients with staged IA, IB, and IIA disease are considered to have early-stage disease, and those with stages IIB (tumor), III (erythroderma), and IV (pathologic nodes with or without viscera) have advanced-stage disease. MF is difficult to cure, and treatment is usually palliative, with the intention of relieving symptoms and improving quality of life although the majority of patients have an indolent form of the disease and will not succumb to the disease. The initial treatment of early-stage disease is primarily skin-directed therapy including topical corticosteroids, topical chemotherapy (nitrogen mustard, carmustine), topical bexaroten (not available in Europe), radiotherapy (total skin electron beam, superficial X-irradiation), and phototherapy. Phototherapy or light therapy is defined as controlled, systematic exposure to artificial, nonionizing radiation. Ultraviolet A (UVA), ultraviolet B (UVB), or a combination of UVA and UVB therapy may be used. The skin is exposed to the light delivered by a phototherapy unit. The most commonly used phototherapies to treat MF include narrow or broad band UVB, or psoralen plus UVA radiation (PUVA). Alternative forms of phototherapies include extracorporeal photochemotherapy, photodynamic therapy, excimer laser, and UVA1. This report focuses on therapy with UVB and PUVA. Indexing Status Subject indexing assigned by CRD MeSH Humans; Mycosis Fungoides; Photochemotherapy; Photosensitizing Agents Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: hayesinfo@hayesinc.com AccessionNumber 32012000160 Date abstract record published 13/07/2012 |
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