背景:自1976年以来,光疗一直是早期真菌病(MF)的一线治疗方法。口服8-甲氧基补骨脂素加紫外线A(口服PUVA)和窄带紫外线B(NB-UVB)是有利的方式,因为它们的可用性。在以往的研究中,最初每周进行三次光疗,这对许多患者来说是不可行的。
目的:评估每周两次口服PUVA和NB-UVB治疗的早期MF患者的初始临床反应和复发时间。
方法:我们回顾了2002-2014年接受口服PUVA或NB-UVB活检证实的MF患者的记录。人口统计数据,分期,对光疗初始疗程的反应,收集初始无复发间隔。
结果:在70名患者中,14(20%)和56(80%)口服PUVA和NB-UVB治疗,分别。大多数人患有早期MF(IA,22.9%,IB,57.1%,IIA,4.3%)。口服PUVA导致2例(14.3%)患者完全缓解(CR),7例(50%)患者部分缓解(PR);17例(30.4%)和25例(44.6%)患者,分别,用NB-UVB实现CR和PR。两组的治疗次数相似。PUVA的累积剂量为520.7J/cm2,NB-UVB的累积剂量为41.6J/cm2。在18个月和9.14个月的随访中,2例(100%)患者和10例(58.8%)口服PUVA和NB-UVB治疗的患者没有初次复发,分别。
结论:早期MF患者口服PUVA和NB-UVB可达到临床反应,每周两次的方案。初始无复发间隔长于1年。
BACKGROUND: Phototherapy has been a first-line treatment for early-stage mycosis fungoides (MF) since 1976. Oral 8-methoxypsoralen plus ultraviolet A (oral PUVA) and narrow-band ultraviolet B (NB-UVB) are favorable modalities owing to their availability. In previous studies, phototherapy was conducted thrice per week initially, which is not feasible for many patients.
OBJECTIVE: To evaluate the initial clinical responses and time to relapse in patients with early-stage MF treated with oral PUVA and NB-UVB at a twice-weekly regimen.
METHODS: We reviewed the records of patients with biopsy-proven MF who received oral PUVA or NB-UVB in 2002-2014. Demographic data, staging, response to initial course of phototherapy, and initial relapse-free interval were collected.
RESULTS: Among 70 patients, 14 (20%) and 56 (80%) were treated with oral PUVA and NB-UVB, respectively. The majority had early-stage MF (IA, 22.9%, IB, 57.1%, and IIA, 4.3%). Oral PUVA led to a complete response (CR) in 2 (14.3%) patients and partial response (PR) in 7 (50%) patients; 17 (30.4%) and 25 (44.6%) patients, respectively, achieved CR and PR with NB-UVB. The number of treatments was similar in both groups. The cumulative dose was 520.7 J/cm2 for PUVA and 41.6 J/cm2 for NB-UVB. There was no initial relapse in the 2 (100%) patients and in 10 (58.8%) patients treated with oral PUVA and NB-UVB at 18 months and 9.14 months of follow-up, respectively.
CONCLUSIONS: Patients with early-stage MF can achieve clinical response with oral PUVA and NB-UVB, with a twice per week regimen. The initial relapse-free interval was longer than 1 year.