窄谱中波紫外线治疗早期蕈样肉芽肿的疗效评估

Assessment of efficacy of narrow-band ultraviolet B for the treatment of early-stage mycosis fungoides

目的 评估窄谱中波紫外线（NB-UVB）治疗早期蕈样肉芽肿（MF）的疗效.方法 采用回顾性研究方式,评估2003年1月至2013年12月期间收治的98例早期MF患者经NB-UVB治疗后的复发率、复发时间,观察该治疗方法的远期不良反应.结果 随访至今获得完全缓解的52例患者,中位照射次数30次（18～87次）,中位累积照射剂量24.16 J/cm2（9.11 ～ 108.86 J/cm2）,中位随访时间41个月（11 ～ 90个月）.14例（26.9％）曾出现复发,中位复发时间为维持治疗结束后8.2个月（3～60个月）,复发患者再次接受NB-UVB治疗,依然能获得完全缓解.不良反应主要包括照射初期的皮肤红斑、瘙痒和照射后暂时性色素沉着.随访患者11～ 90个月,未发现有皮肤癌的发生.结论 NB-UVB光疗治疗早期MF疗效好,所有随访患者均未见皮肤癌发生,虽有一定复发性,但重复治疗依然有效.

Objective To evaluate the efficacy of narrow-band ultraviolet B （NB-UVB） for the treatment of early-stage mycosis fungoides （MF）.Methods A retrospective study was performed on 98 patients with early-stage MF treated with NB-UVB from January 2003 to December 2013.The rate of and time to recurrence of MF were assessed,and long-term side effects were evaluated in these patients.Results Among 52 patients achieving complete remission,the median number of sessions of NB-UVB radiation was 30 （range,18-87）,the median cumulative radiation dose was 24.16 J/cm2 （range,9.11-108.86 J/cm2）,and the median follow-up duration was 41 months （range,11-90 months）.Relapse occurred in 14 （26.9%） patients with the median time to recurrence being 8.2 months （range,3-60 months）.The patients suffering from relapse achieved complete remission after treatment with NB-UVB again.Adverse reactions mainly included skin erythema and itching at the early stage of radiation,as well as temporary pigmentation after radiation.Cutaneous carcinoma occurred in none of these patients during 11-90 months of follow-up.Conclusions NB-UVB phototherapy appeared to be effective for the treatment of early-stage MF,and no cutaneous carcinoma occurred in these patients during the follow-up.Although MF may relapse in some cases,repeated NB-UVB phototherapy is still effective.