Prognostic signs and the management of the mycosis fungoides

Abstract

A total of 132 patients with biopsy-proven mycosis fungoides were treated by total skin irradiation with 2.5 MeV electrons. In 58% a complete remission of cutaneous manifestations was observed. The rate of complete remission was dose-dependent and was inversely dependent on the extent of disease. Fourteen patients had disease-free survivals of 3–14 years following a single course of treatment, and may be considered as cured. Fifty-six patients died, 52% of whom succumbed to extracutaneous involvement with disease. Extracutaneous involvement correlated with the extent of skin involvement, and with the presence of initial lymphadenopathy, and was associated with poor prognosis. A new staging classification is proposed which provides a rational basis for the introduction of new treatment modalities for the management of mycosis fungoides patients.