CTCL is a highly radiosensitive malignancy, and localised superficial radiotherapy is an invaluable palliative therapy for patients with all stages of mycosis fungoides. Treatment should be palliative except for patients with solitary localised disease where "cure" is possible. Although in-field recurrence rates were very low for lesions treated with >3000 cGy, the number of lesions treated with this dose was very low compared with the other groups and this form of therapy is only palliative in mycosis fungoides because disease is multifocal. Therefore the use of high-dose fractionation regimens for individual lesions should be avoided in mycosis fungoides because CR rates are similar to those for low-dose regimens (see above) and recurrent disease adjacent to previously treated fields can be treated with overlapping fields if necessary. However, treatment of disease on the lower legs can be difficult in view of a higher risk of radiation necrosis with repeated treatments.
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