Minimal stage IA mycosis fungoides. Results of radiotherapy in 15 patients

Background: Mycosis fungoides (MF) minimal disease stage IA, characterized by one or few close lesions (up to four), has been considered a distinct entity with a favourable prognosis, where local treatment such as radiotherapy could afford long-lasting remissions. Objective: To review our experience in radiologic treatment of this subset of the disease and compare our results with those reported in the literature. Methods: Fifteen patients presenting with MF minimal disease were treated with localized superficial X-ray therapy, with a total median dose of 22 Gy. Results: At 1 month from the end of radiotherapy, complete remission was observed in 95.45% of irradiation fields and partial remission in 4.54%. The 5-year local progression-free rate was 93.75%, while the overall relapse-free rate at 5 and 10 years was 51%. Conclusions: After an excellent response to radiotherapy, MF minimal disease may experience local or distant failures, even after years. The identification of an optimal dose of radiation and the collection of more cases would be useful in giving new guidelines in the treatment of this subset of the disease.