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Selected Publication:
Sugic, A.
A prospective cross-over comparison between narrowband UVB (311nm) and PUVA therapy for the treatment of patch-stage mycosis fungoides.
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 46
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- Authors Med Uni Graz:
- Wolf Ingrid
- Advisor:
- Hofer Angelika
- Wolf Ingrid
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- Abstract:
- Introduction: Narrowband ultraviolet B (NB-UVB) has been reported to clear patch-stage mycosis fungoides (MF) with fewer side effects compared to psoralen plus long-wave ultraviolet A (PUVA) therapy. However, particularly for patients with early-stage MF, it remains unclear which phototherapy provides the best outcome. Objectives: The aim of the present study was to compare the primary response rate and the relapse-free intervals after the treatment of patch-stage MF with NB-UVB and PUVA. Method: Between 2000 and 2009 eighteen Caucasians (6 women, 12 men; mean age: 64 years) with clinically and histologically confirmed patch-stage MF (stage IA and IB) were enrolled in this prospective cross-over study. Patients were treated 3 times per week with either NB-UVB or PUVA and treatment was stopped as soon as skin lesions had cleared. Those patients, who relapsed after the first phototherapy regimen, were then treated with the other phototherapy regimen. The relapse-free interval in follow-up period 1 after the first treatment regimen (NB-UVB or PUVA) and in follow-up period 2 after the second treatment regiment (PUVA or NB-UVB) was observed and compared. Relapse-free intervals after all NB-UVB and PUVA treatments were also analysed. Results: All patients cleared (with more than 95% resolution of skin lesions) at the end of each treatment regimen. No significant difference was detected between the treatments in terms of number of treatments, mean treatment duration and irradiation dose. Six (33%) patients were treated with a single treatment (NB-UVB or PUVA), because they did not show a relapse within the study observation period. Whereas 12 (67%) patients relapsed after the first treatment regimen and therefore received both NB-UVB and PUVA therapy (cross-over patients). Overall, 16 patients with NB-UVB treatments and 14 patients with PUVA treatments were analysed. The relapse-free intervals were not statistically significant (p=0.66) between the two treatment modalities. The median relapse-free interval was 12 months after the first treatment regimen with NB-UVB or PUVA and 8 months after the second treatment regimen with PUVA or NB-UVB (p=0.019). Disease stage was a significant risk factor for relapse. The number of side effects was lower in the NB-UVB treated group compared to the PUVA group. Conclusion: NB-UVB and PUVA seem to be equal treatment modalities for patch-stage MF (IA and IB) in relation to clearing of lesion and relapse-free interval.