lymphoma aData from Willemze R, Jaffe ES, Burg G, et al.: WHO-EORTC classification for cutaneous lymphomas. Blood 105:3768-3785, 2005.

lymphoma aData from Willemze R, Jaffe ES, Burg G, et al.: WHO-EORTC classification for cutaneous lymphomas. Blood 105:3768-3785, 2005.

median radiation dose was 40 Gy, and ranged from 20 to 48 Gy. Patients receiving doses less than 36 Gy showed an increased risk of recurrence.

Eich et al. retrospectively examined 35 patients with PCBCL, mostly with FCCL.10 Four patients were identified with LBCL of the leg. They treated 32 patients with electron beam radiation (5-12 MeV), 2 with photon beam radiation (5 MV), and 1 with a combination thereof (5 MeV, 6 MV). Thirty-four patients achieved a CR after initial treatment. However, cutaneous relapses occurred in 31% of patients, mostly at nonirradiated sites. Five-year relapse-free survival of all patients was 50%, with a 5-year overall survival of 75%. Median dose to target was 45 Gy, and ranged from 27 to 54 Gy with a median fractionated dose of 1.8 Gy. Reported radiation margins ranged from 2 on the head to 5 cm on the trunk and extremities. Treatment was generally well tolerated with documented grade I reactions in 30 patients (86%) according to EORTC criteria14 and teleangiecta-sia in 3 patients after a median of 3 years.

Kirova et al. reported 25 patients treated with initial radiation, with similar results.11 All patients were treated with electron beam therapy delivered with electrons of 8-MeV energy and total doses ranging from 30 to 40 Gy. Depending on the extent of skin disease, either extended field or localized field irradiation was used. A healthy skin margin of at least 2.5 cm was included in the radiation field. The CR rate was 92%, with a 5-year overall survival of 75%. The 5-year disease-free survival was 75%. Relapses occurred between 2 months and 13 years in 16% of the patients, primarily in unirradiated sites. Side effects were usually grade I reactions at presentation, with occurrence of skin cancer in one patient after 10 years.

Rijlaarsdam et al. reported 55 patients with FCCL. Forty patients received radiation therapy.12 Thirty-one were treated with electron beam, eight with photon beam equipment, and one with orthovolt radiation. Doses ranged from 30 to 40 Gy with 2-cm safety margins. All patients achieved CR. The reported relapse rate was 20% (8 patients). Four patients had leg involvement. A better estimated 5-year survival rate of 89% for all patients was reported, which might be related to the indolent nature of FCCL. Three patients with tumors on the legs died of disease.

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