Combination TSEB regimens

An RCT in 103 CTCL patients comparing TSEB and multi-agent chemotherapy (CAVE) with sequential topical therapy including superficial radiotherapy and phototherapy revealed a higher CR rate in the TSEB/chemotherapy group (38% compared with 18%; P= 0-032) but after a median follow up of 75 months DFS and OS did not differ significantly.77

A retrospective non-randomised study comparing TSEB (32-40 Gy) alone with TSEB followed by

ECP (given 2 days monthly for a median of 6 months) in 44 patients with erythrodermic CTCL (57% stage III, 30% stage IVA, 13% stage IVB/overall 59% had haematological involvement B1) has reported an overall CR rate of 73% after TSEB, with a 3-year DFS of 49% for 17 patients who received only TSEB (OS 63%) and 81% for 15 patients who received TSEB followed by ECP (OS 88%).78 A multivariate analysis suggested that the combination of TSEB and ECP was significantly associated with a prolonged disease-free and cause-specific survival when corrected for peripheral blood involvement (B1) and stage of disease.

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