|
1
|
Elsayad K, Guenova E, Fournier B, Fernandes C, Clementel E, Papadavid E, Barry MB, Pavlotsky F, Assaf C, Ortiz-Romero PL, Kouloulias V, de Masson A, Dalle S, Clavère P, Schlaak M, Booken N, Wobser M, Mitteldorf C, Aviv B, Mareco V, Gallardo F, Dummer R, Gross M, Ehret F, Lancia A, Tomasik B, Hawley L, Rermouchamps V, Ibrahim MAH, Gawish A, Abouegylah M, Stuschke M, Baten A, Eich HT, Specht L, Levis M, Morris S, Campbell B, Nicolay JP, Cowan R, Correia D. Real-World Pattern-of-Care Analysis of Primary Cutaneous Lymphomas Radiation Therapy Among European Organisation for Research and Treatment of Cancer Members. Int J Radiat Oncol Biol Phys 2025; 121:1006-1010. [PMID: 39549760 DOI: 10.1016/j.ijrobp.2024.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 10/30/2024] [Accepted: 11/07/2024] [Indexed: 11/18/2024]
Abstract
PURPOSE We aim to determine the current treatment patterns and recommendations among physicians for cutaneous lymphomas and to identify the types of skin lymphomas for which existing radiation regimens need improvement. METHODS AND MATERIALS A questionnaire from the European Organisation for Research and Treatment of Cancer was distributed to all members of the Cutaneous Lymphoma Tumour Group and Radiation Oncology Scientific Council. This online survey included 13 questions regarding treatment practices for patients with cutaneous lymphoma. The survey was conducted from August 21 to December 18, 2023. Frequency distributions and subgroup comparisons were calculated and analyzed. RESULTS We collected 51 completed questionnaires from investigators from 19 countries specializing in cutaneous lymphoma treatment. Radiation doses varied significantly (range, 4-60 Gy). Based on the histologic entity, up to one-third of the investigators delivered hypofractionated regimens (range, 14%-35%). Reduced-dose radiation therapy (RT) was considered by 27% to 63% of investigators. Meanwhile, 18 (35%) investigators considered adapting the radiation dose to the response to immunochemotherapy when treating primary cutaneous diffuse large B cell lymphoma-leg type. Regarding total skin electron beam therapy, 91% of centers delivered reduced-dose regimens, and 18% of investigators applied ultrahypofractionated protocols. CONCLUSIONS RT in patients with cutaneous lymphoma is highly heterogeneous among the European Organisation for Research and Treatment of Cancer centers. The development of evidence-based recommendations for RT dose, fractionation, and technique for cutaneous lymphomas is required for optimization and standardization of treatment.
Collapse
Affiliation(s)
- Khaled Elsayad
- Radiation Oncology, University Hospital of Muenster, Muenster, Germany; Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, Marburg, Germany; Department of Radiotherapy and Radiation Oncology, Philipps-Universität Marburg, Marburg, Germany; Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, Marburg, Germany; University Cancer Center (UCT) Frankfurt - Marburg, Marburg, Germany.
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; University Institute and Clinic for Immunodermatology, Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Beatrice Fournier
- European Organisation for Research and Treatment of Cancer, Headquarters, Brussels, Belgium
| | - Carolina Fernandes
- European Organisation for Research and Treatment of Cancer, Headquarters, Brussels, Belgium
| | - Enrico Clementel
- European Organisation for Research and Treatment of Cancer, Headquarters, Brussels, Belgium
| | - Evangelia Papadavid
- 2nd Department of Dermatology, National and Kapodistrian University of Athens, Attikon University Hospital, Greece
| | - Marie Beylot Barry
- Department of Dermatology, University Hospital of Bordeaux and INSERM U1312, France
| | - Felix Pavlotsky
- Dermatology Department, Sheba Medical Center Tel Hashomer, Israel
| | - Chalid Assaf
- Department of Dermatology, HELIOS Klinikum Krefeld, Krefeld, Germany; Institute for Molecular Medicine, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany; Department of Dermatology, HELIOS Klinikum Schwerin, University Campus of The Medical School Hamburg, Schwerin, Germany
| | - Pablo L Ortiz-Romero
- Department of Dermatology, Institute i+12, Hospital 12 de Octubre Medical School, University Complutense, Madrid, Spain
| | - Vassilis Kouloulias
- Department of Radiation Oncology, National and Kapodistrian University of Athens, Attikon University Hospital, Greece
| | - Adele de Masson
- Department of Dermatology, APHP, Saint-Louis University Hospital, Paris, France
| | - Stephane Dalle
- Department of Dermatology, Hospices Civils de Lyon, Pierre Bénite CEDEX, France
| | - Pierre Clavère
- Department of Radiotherapy, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Max Schlaak
- Department of Dermatology, Venereology and Allergology, Charite - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nina Booken
- Department of Dermatology and Venerology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Wobser
- Department of Dermatology, Universitaetsklinikum Wuerzburg, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Germany
| | - Barzilai Aviv
- Dermatology Department, Sheba Medical Center Tel Hashomer, Israel
| | - Virgínia Mareco
- Radiotherapy Department, Unidade Local de Saúde Santa Maria, EPE, Portugal
| | | | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Switzerland
| | - Markus Gross
- Department of Radiooncology, University Hospital Basel, Basel, Switzerland
| | - Felix Ehret
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiation Oncology, Berlin, Germany
| | - Andrea Lancia
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Bartłomiej Tomasik
- Department of Oncology and Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Lorna Hawley
- Bristol Haematology and Oncology Centre, Bristol, United Kingdom
| | - Vincent Rermouchamps
- Radiation Oncology Department, CHU UCL Namur, Site Sainte Elisabeth, Namur, Belgium
| | | | - Ahmed Gawish
- Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, Marburg, Germany; Department of Radiotherapy and Radiation Oncology, Philipps-Universität Marburg, Marburg, Germany; Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, Marburg, Germany; University Cancer Center (UCT) Frankfurt - Marburg, Marburg, Germany
| | - Mohamed Abouegylah
- Department of Clinical Oncology, Alexandria University Hospital and Ayadi Al-Motakbal Hospital, Alexandria, Egypt
| | - Martin Stuschke
- Department of Radiation Oncology, University Hospital Essen, Germany
| | - Adinda Baten
- Department of Radiation Oncology, UZ Leuven, Leuven, Belgium
| | - Hans Theodor Eich
- Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Lena Specht
- Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mario Levis
- Department of Oncology University of Torino, Torino, Italy
| | - Stephen Morris
- Guy s and St Thomas' NHS - Guy's Hospital, London, United Kingdom
| | - Belinda Campbell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia; Department of Clinical Pathology, University of Melbourne, Parkville, Victoria, Australia
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany
| | - Richard Cowan
- Department of Clinical Oncology, Christie Hospital, University of Manchester, Manchester, United Kingdom
| | - Dora Correia
- Department of Radiation Oncology, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| |
Collapse
|
|
2
|
Elsayad K, Guenova E, Assaf C, Nicolay JP, Trautinger F, Stadler R, Waldstein C, Boterberg T, Meijnders P, Kirova Y, Dobos G, Duque-Santana V, Riggenbach E, Elsheshtawy W, Niezink A, Papadavid E, Scarisbrick J, Vermeer M, Neelis KJ, Bagot M, Battistella M, Quaglino P, Knobler R, Kempf W, Maklad A, Adeberg S, Kouloulias V, Simontacchi G, Corradini S, König L, Eich HT, Cowan R, Correia D. Radiotherapy in cutaneous lymphomas: Recommendations from the EORTC cutaneous lymphoma tumour group. Eur J Cancer 2024; 212:115064. [PMID: 39418694 DOI: 10.1016/j.ejca.2024.115064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 09/29/2024] [Accepted: 10/04/2024] [Indexed: 10/19/2024]
Abstract
The number of primary cutaneous lymphoma patients receiving low-dose radiotherapy is increasing, though controlled clinical trials defining the standard radiation dose for each specific entity have not yet been completed. Radiation oncologists are left with making highly individualized decisions that would be better enriched by additional clinical evidence. In this expert opinion, we aim to provide a clear recommendation to improve the current practice of radiation oncology. In addition, existing literature has been reviewed to develop recommendations for all types of primary cutaneous lymphoma. A prospective trial is urgently needed to identify the factors influencing patient outcomes following different radiation doses.
Collapse
Affiliation(s)
- Khaled Elsayad
- Radiation Oncology, University Hospital of Münster, Münster, Germany; Department of Radiation Oncology, UKGM Marburg, Marburg, Germany; Marburg Ion-Beam Therapy Center (MIT), Department of Radiation Oncology, UKGM Marburg, Marburg, Germany; University Cancer Center (UCT) Frankfurt-Marburg, Marburg, Frankfurt, Germany.
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; University Institute and Clinic for Immunodermatology, Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Chalid Assaf
- Institute for Molecular Medicine, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany; Department of Dermatology, HELIOS Klinikum Krefeld, Krefeld, Germany, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Rudolf Stadler
- Department of Dermatology, Johannes Wesling Medical Centre, University of Bochum, Minden, Germany
| | - Cora Waldstein
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria
| | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, Belgium
| | - Paul Meijnders
- Iridium Netwerk, University of Antwerp, Antwerp, Belgium
| | - Youlia Kirova
- Department of Radiation Oncology, Institut Curie, Hopital de Paris, France
| | - Gabor Dobos
- Department of Dermatology, Charite - Universitaetsmedizin Berlin - Campus Mitte, Germany
| | - Victor Duque-Santana
- Department of Radiation Oncology, Quironsalud Madrid University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Spain
| | - Elena Riggenbach
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Wael Elsheshtawy
- Department of Clinical Oncology, Al Azhar University, Cairo, Egypt
| | - Anne Niezink
- Department of Radiation Oncology, University Medical Center Groningen, the Netherlands
| | - Evangelia Papadavid
- National and Kapodistrian University of Athens, 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - Julia Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, UK
| | - Maarten Vermeer
- Head of Department of Dermatology, Leiden University Medical Center, the Netherlands
| | - Karen J Neelis
- Department of radiotherapy, Leiden University Medical Center, the Netherlands
| | - Martine Bagot
- Department of Dermatology, Hopital Saint Louis, Université Paris Cité, INSERM U976, Paris, France
| | - Maxime Battistella
- APHP Department of Pathology, INSERM U976, University Paris Cité, Saint-Louis University Hospital, Paris, France
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Robert Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Affolternstrasse 56, CH-8050 Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Ahmed Maklad
- Department of Radiation Oncology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sebastian Adeberg
- Department of Radiation Oncology, UKGM Marburg, Marburg, Germany; Marburg Ion-Beam Therapy Center (MIT), Department of Radiation Oncology, UKGM Marburg, Marburg, Germany; University Cancer Center (UCT) Frankfurt-Marburg, Marburg, Frankfurt, Germany
| | - Vassilis Kouloulias
- Department of Radiation Oncology, National and Kapodistrian University of Athens, Athens, Greece
| | - Gabriele Simontacchi
- Department of Radiation Oncology, DAI Oncologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | - Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans Theodor Eich
- Radiation Oncology, University Hospital of Münster, Münster, Germany
| | - Richard Cowan
- Department of Clinical Oncology, Christie Hospital, University of Manchester, Manchester, United Kingdom
| | - Dora Correia
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Radiation Oncology, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| |
Collapse
|