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Despite the lack of controlled trials, PUVA remains one of the most useful skin-directed therapies for early stages of mycosis fungoides. RCTs comparing PUVA with TL-01 and topical mechlorethamine would be helpful in early-stage disease (IA/IB). Duration of response and DFS/OS data are also urgently required. The role of maintenance therapy is unclear but high cumulative doses entail a significant risk of squamous cell carcinoma. DFS and OS rates in patients treated with topical chemotherapy, phototherapy and TSEB are difficult to compare without RCTs, but there appears to be little difference in early-stage disease, which emphasises the urgent need for RCTs.

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