Radiotherapy in cutaneous lymphomas: Recommendations from the EORTC cutaneous lymphoma tumour group

Khaled Elsayad¹, Emmanuella Guenova², Chalid Assaf³, Jan P Nicolay⁴, Franz Trautinger⁵, Rudolf Stadler⁶, Cora Waldstein⁷, Tom Boterberg⁸, Paul Meijnders⁹, Youlia Kirova¹⁰, Gabor Dobos¹¹, Victor Duque-Santana¹², Elena Riggenbach¹³, Wael Elsheshtawy¹⁴, Anne Niezink¹⁵, Evangelia Papadavid¹⁶, Julia Scarisbrick¹⁷, Maarten Vermeer¹⁸, Karen J Neelis¹⁹, Martine Bagot²⁰, Maxime Battistella²¹, Pietro Quaglino²², Robert Knobler²³, Werner Kempf²⁴, Ahmed Maklad²⁵, Sebastian Adeberg²⁶, Vassilis Kouloulias²⁷, Gabriele Simontacchi²⁸, Stefanie Corradini²⁹, Laila König³⁰, Hans Theodor Eich³¹, Richard Cowan³², Dora Correia³³

Affiliations

¹ 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. Electronic address: khaled.elsayad@uk-gm.de.
² 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.
³ 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.
⁴ Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany.
⁵ Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.
⁶ Department of Dermatology, Johannes Wesling Medical Centre, University of Bochum, Minden, Germany.
⁷ Department of Radiation Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria.
⁸ Department of Radiation Oncology, Ghent University Hospital, Belgium.
⁹ Iridium Netwerk, University of Antwerp, Antwerp, Belgium.
¹⁰ Department of Radiation Oncology, Institut Curie, Hopital de Paris, France.
¹¹ Department of Dermatology, Charite - Universitaetsmedizin Berlin - Campus Mitte, Germany.
¹² Department of Radiation Oncology, Quironsalud Madrid University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Spain.
¹³ Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹⁴ Department of Clinical Oncology, Al Azhar University, Cairo, Egypt.
¹⁵ Department of Radiation Oncology, University Medical Center Groningen, the Netherlands.
¹⁶ National and Kapodistrian University of Athens, 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece.
¹⁷ Department of Dermatology, University Hospital Birmingham, Birmingham, UK.
¹⁸ Head of Department of Dermatology, Leiden University Medical Center, the Netherlands.
¹⁹ Department of radiotherapy, Leiden University Medical Center, the Netherlands.
²⁰ Department of Dermatology, Hopital Saint Louis, Université Paris Cité, INSERM U976, Paris, France.
²¹ APHP Department of Pathology, INSERM U976, University Paris Cité, Saint-Louis University Hospital, Paris, France.
²² Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
²³ Department of Dermatology, Medical University of Vienna, Vienna, Austria.
²⁴ Kempf und Pfaltz Histologische Diagnostik, Affolternstrasse 56, CH-8050 Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, CH-8091 Zurich, Switzerland.
²⁵ Department of Radiation Oncology, King Fahad Medical City, Riyadh, Saudi Arabia.
²⁶ 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.
²⁷ Department of Radiation Oncology, National and Kapodistrian University of Athens, Athens, Greece.
²⁸ Department of Radiation Oncology, DAI Oncologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
²⁹ Radiation Oncology, LMU University of Munich, 81388 Munich, Germany.
³⁰ Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
³¹ Radiation Oncology, University Hospital of Münster, Münster, Germany.
³² Department of Clinical Oncology, Christie Hospital, University of Manchester, Manchester, United Kingdom.
³³ Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Radiation Oncology, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland.

PMID: 39418694
DOI: 10.1016/j.ejca.2024.115064

Free article

Review

Radiotherapy in cutaneous lymphomas: Recommendations from the EORTC cutaneous lymphoma tumour group

Khaled Elsayad et al. Eur J Cancer. 2024 Nov.

Free article

. 2024 Nov:212:115064.

doi: 10.1016/j.ejca.2024.115064. Epub 2024 Oct 8.

Authors

Affiliations

¹ 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. Electronic address: khaled.elsayad@uk-gm.de.
² 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.
³ 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.
⁴ Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany.
⁵ Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.
⁶ Department of Dermatology, Johannes Wesling Medical Centre, University of Bochum, Minden, Germany.
⁷ Department of Radiation Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria.
⁸ Department of Radiation Oncology, Ghent University Hospital, Belgium.
⁹ Iridium Netwerk, University of Antwerp, Antwerp, Belgium.
¹⁰ Department of Radiation Oncology, Institut Curie, Hopital de Paris, France.
¹¹ Department of Dermatology, Charite - Universitaetsmedizin Berlin - Campus Mitte, Germany.
¹² Department of Radiation Oncology, Quironsalud Madrid University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Spain.
¹³ Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹⁴ Department of Clinical Oncology, Al Azhar University, Cairo, Egypt.
¹⁵ Department of Radiation Oncology, University Medical Center Groningen, the Netherlands.
¹⁶ National and Kapodistrian University of Athens, 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece.
¹⁷ Department of Dermatology, University Hospital Birmingham, Birmingham, UK.
¹⁸ Head of Department of Dermatology, Leiden University Medical Center, the Netherlands.
¹⁹ Department of radiotherapy, Leiden University Medical Center, the Netherlands.
²⁰ Department of Dermatology, Hopital Saint Louis, Université Paris Cité, INSERM U976, Paris, France.
²¹ APHP Department of Pathology, INSERM U976, University Paris Cité, Saint-Louis University Hospital, Paris, France.
²² Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
²³ Department of Dermatology, Medical University of Vienna, Vienna, Austria.
²⁴ Kempf und Pfaltz Histologische Diagnostik, Affolternstrasse 56, CH-8050 Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, CH-8091 Zurich, Switzerland.
²⁵ Department of Radiation Oncology, King Fahad Medical City, Riyadh, Saudi Arabia.
²⁶ 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.
²⁷ Department of Radiation Oncology, National and Kapodistrian University of Athens, Athens, Greece.
²⁸ Department of Radiation Oncology, DAI Oncologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
²⁹ Radiation Oncology, LMU University of Munich, 81388 Munich, Germany.
³⁰ Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
³¹ Radiation Oncology, University Hospital of Münster, Münster, Germany.
³² Department of Clinical Oncology, Christie Hospital, University of Manchester, Manchester, United Kingdom.
³³ Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Radiation Oncology, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland.

PMID: 39418694
DOI: 10.1016/j.ejca.2024.115064

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.

Keywords: Hypofractionation; Leg type; Low-dose radiotherapy; Mycosis fungoides; Primary cutaneous diffuse large B-cell lymphoma; Primary cutaneous follicular centre lymphoma; Primary cutaneous marginal zone lymphoma; Sézary syndrome; Total skin electron beam.

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Conflict of interest statement

Declaration of Competing Interest Khaled Elsayad: received consulting and lecture fees from Kyowa Kirin and Gilead Sciences. Franz Trautinger: received consulting and lecture fees from Kyowa Kirin, Recordati Rare Diseases and Takeda. Maxime Battistella: received consulting and lecture fees from Kyowa Kirin, Innate Pharma, and Takeda. All remaining authors have declared no conflicts of interest.

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Radiotherapy in cutaneous lymphomas: Recommendations from the EORTC cutaneous lymphoma tumour group

Affiliations

Radiotherapy in cutaneous lymphomas: Recommendations from the EORTC cutaneous lymphoma tumour group

Authors

Affiliations

Abstract

Conflict of interest statement

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LinkOut - more resources

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Medical