Narrow-band ultraviolet B (NB UVB) is a disease-modifying treatment with curative potential for stage I mycosis fungoides (MF), with a large proportion of individuals achieving disease-free survival (DFS) of >5 years, according to the results of a retrospective cohort study published in the Journal of the American Academy of Dermatology.
The investigators sought to evaluate long-term DFS following NB UVB therapy in patients with stage I MF. A historic cohort of all patients with stage I MF who had achieved complete remission with NB UVB and had discontinued any treatment prior to 2011 were assessed.
Data were collected with respect to gender, age at beginning of phototherapy, disease stage, skin phototype, number of treatments, total dose used, and length of DFS.
Among a total of 117 patients who had begun NB UVB, 80% achieved complete remission and 60% were disease free as of March 2017. Based on multivariate analysis, only age and disease stage independently affected DFS. The DFS was significantly longer among those patients who were <50 years of age vs those who were >50 years of age (124 months vs 91 months, respectively; P =.01). Similarly, DFS was significantly longer among patients with stage IA MF vs those with stage IB MF (131 months vs 87.6 months, respectively; P =.001).
The DFS for patients receiving a total cumulative NB UVB dose of <40 kJ/cm2 was 123 months, compared with 91 months among those who received a higher cumulative NB UVB dose (P =.015). Gender and skin phototype did not have any effect on disease recurrence rate.
The investigators concluded that NB UVB is a promising therapy for MF with good curative potential. Younger patients with stage IA disease have a better likelihood of attaining this outcome.
Felix P, Marwan D, Aviv B. The potential of narrow band UVB to induce sustained durable complete remission off-therapy in stage I mycosis fungoides [published online May 22, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.05.023