ABSTRACT
BACKGROUND: Since the observation of new cases of primary cutaneous anaplastic large cell lymphoma (PCALCL) with a seemingly aggressive clinical presentation and a favorable response to radiation therapy (RT), a review of our series has been performed to evaluate the results of RT. MATERIALS AND METHODS: The study is a retrospective analysis of 30 patients with PCALCL treated with conventional energy RT. RESULTS: About 55 fields of irradiation were performed. Complete clinical response (CCR) was obtained in 29 cases and a partial clinical response (PCR) in one. Two lesions had a marginal relapse at 7 and 37 months, respectively. In eight cases, new lesions appeared in the same body district and in six cases, in body sites at distance from the field of treatment. Total radiation dose ranged from 15 to 35 Gy (median 25 Gy). Follow-up range was 2-218 months (median 38.5 months) with a local control rate of 85% and a relapse-free rate of 49% at 5 years from RT. Three cases developed a nodal involvement. CONCLUSIONS: PCALCL belongs to the group of primary cutaneous CD30+ lymphoproliferative disorders, accounting for 25-30% of cutaneous T-cell lymphomas. RT is considered of choice as alternative to surgical excision of solitary lesions. Recent studies have focused on ideal dose to obtain local control indicating 30 Gy as adequate, but others have hypothesized that lower doses may suffice. Our study confirms the excellent role of RT in the local control of the disease with total doses ≤25 Gy.
Subject(s)
Lymphoma, Primary Cutaneous Anaplastic Large Cell/radiotherapy , Neoplasm Recurrence, Local/epidemiology , Skin Neoplasms/radiotherapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Disease-Free Survival , Dose-Response Relationship, Radiation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/prevention & control , Radiotherapy Dosage , Retrospective Studies , Young AdultABSTRACT
Retinoic acid is a physiological compound of human blood. Blood levels range from 1000 to 7000 pg/mL (usually 1500-5000 pg/mL). Results of studies on absorption of topical retinoic acid in laboratory animals, although rather conflicting, demonstrate that it induces plasma concentrations which are well below concentrations caused by non-teratogenic oral doses. In humans, minimal percutaneous absorption of tretinoin was observed after topical applications. Neither single dose nor long-term treatment with topical tretinoin affect the endogenous levels of retinoic acid or its metabolites. Topical application of tretinoin at doses used in acne unlikely induces systemic effects. Although some clinical cases of suspected tretinoin-related embryotoxicity have been described, three prospective cohort studies clearly demonstrated the safety of topical tretinoin as an embryotoxic agent.
