Radiotherapy in the management of cutaneous B-cell lymphoma. Our experience in 25 cases.

PURPOSE: To report our results in the treatment with radiation therapy of 25 patients affected by B-cell lymphoma with initial cutaneous presentation.

MATERIALS AND METHODS: From October 1978 to June 1997, we have treated 25 patients with cutaneous B-cell lymphoma (CBCL) by cutaneous irradiation. There were 17 males and eight females, aged from 23 to 89 years (median age 50 years). The mean follow-up time for the series was 3.9 years (range from 0.2 to 15 years) from the completion of radiation therapy. All patients were staged as follows: in group 1, single lesion; group 2, multiple lesions; group 3, disseminated lesions. There were six (24%) patients in group 1, 15 (60%) patients in group 2, and four (16%) in group 3. There were nine patients with head and neck lesions, 11 patients with trunk lesions, and five patients with leg lesions. Thirteen patients (52%) had previously received chemotherapy for CBCL. Extended field irradiation was used to treat six patients (24%). Localized field irradiation (LFI) was performed for the other 19 patients (76%).

RESULTS: The overall survival rate at 5 years was 73%. The complete response (CR) to the treatment for our series was 92%. The length of complete remission ranged from 2 to 180 months. There were three patients (8%) who obtained partial response (PR). Disease-free survival (DFS) at 1 year was 91% and at 5 years was 75%. Radiotherapy was generally well tolerated.

CONCLUSIONS: Localized field irradiation is an effective treatment for some localized forms of primary cutaneous B-cell lymphoma and can obtain prolonged remissions. The patients with wide-spread skin involvement are usually candidates for extended field irradiation and/or chemotherapy. For the advanced stages of cutaneous B-cell lymphoma, where the chemotherapy is the treatment of choice, some good palliation can be achieved using local field irradiation.