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Introduction: Total skin electron irradiation (TSEI) therapy is the treatment of choice for mycosis fungoides. However, conventional TSEI therapy is time cons uming as well as patient unfriendly. Therefore we used high-dose rate (HDR) mode TSEI in these patients. High-dose rate mode of TSEI is a technolog ical innovation attached to a Linear Accelerator (Philips, SL-20, Netherlands), which can deliver an electron beam of 30 Gy/min at the iso-center. The iso-center faces the patient, 100 cm away from the target of the linear accelerator. The patient is treated at a distance of 10 feet from the iso-center of the linear accelerator. The dose delivered to the skin was 1.13 Gy/min, making the treatm ent execution much easier and patient compliancemuch better. Methods: Seven male patients between 40 and 64 years in age having mycosis fungoides for 9-18 mont hs were treated by TSEI using high-dose rate mode between 1998 and 2000. The TS EI was performed according to the Stanford technique, delivering a total dose of 36 Gy. Each patient received a dose of 1.2 Gy/field/day. There were six fields, i.e. anterior, posterior, left and right anterior obliques, and left and right posterior obliques in both the upper and lower parts of the body. The eyes and n ails were shielded at each session of radiotherapy. The times taken at each sess ion of the therapy and radiation-associated side-effects were determined in ea ch patient. The patients were followed up to 26 months (median 9 months) to look for any relapse. Results: Three patients had early stage disease (IB) whereas f our patients had advanced disease (IIB). Six patients out of these had complete remission following TSEI while one patient died as a result of progression of th e disease during treatment. The treatment time taken at each treatment session i n each individual patient was approximately 15 min. Radiation-associated morbid ity was seen in all patients. Cutaneous lesions relapsed in two patients after 4 and 10 months, respectively, while four patients were alive without the disease at the end of 2 years. Conclusions: Total skin electron irradiation using high -dose rate mode delivery of electrons is an easy, better, compliant and effecti ve therapeutic modality for treatment of mycosis fungoides with an acceptable range of toxicities.
However, conventional TSEI therapy is time consuming as well as patient unfriendly. Therefore we used high-dose rate (HDR) mode TSEI in these patients. High-dose rate mode of TSEI is a technologic ical innovation attached to a Linear Accelerator (Philips, SL-20, Netherlands), which can deliver an electron beam of 30 Gy / min at the iso-center. patient, 100 cm away from the target of the linear accelerator. The patient is treated at a distance of 10 feet from the iso-center of the linear accelerator. The dose delivered to the skin was 1.13 Gy / min, making the treat entitment Methods: Seven male patients between 40 and 64 years in having mycosis fungoides for 9-18 mont hs were treated by TSEI using high-dose rate mode between 1998 and 2000. The TS EI was performed according to the Stanford technique, de There were six fields, ie anterior, posterior, left and right anterior obliques, and left and right posterior obliques in both the upper and lower parts of the body. The eyes and n ails were shielded at each session of radiotherapy. The times taken each each sess ion of the therapy and radiation-associated side-effects were determined in e ch patient. The patients were followed up to 26 months ( Six patients out of these had complete remission the following TSEI while one patient died as a result of progression of th e disease during treatment. The treatment time taken at each treatment session in each individual patient was approximately 15 min. Radiation-associated morbid ity was seen in all patients. Cutaneous lesions relapsed in two patients after 4 and 10 months, respectively, while four patients were alive without the disease at the end of 2 years. Conclusions: Total skin electron irradiation using high-rate mode delivery of electrons is an easy, better, compliant and effecti ve therapeutic modality for treatment of mycosis fungoides with an acceptable range of toxicities