Treatment of Stage I and Stage II Mycosis Fungoides

Several forms of treatment can completely resolve skin lesions at stages I and II, so the choice of therapy depends on local expertise and the facilities available. With therapy, the survival of patients with stage IA disease can be expected to be the same as for age- and sex-matched controls.[1-3]

There is no curative therapy and no clear difference in overall survival (OS) among the treatment options for patients with stage I and stage II mycosis fungoides.

A randomized study of 103 patients compared combined total-skin electron-beam radiation (TSEB) plus combination chemotherapy with sequential topical therapies.[4] In the latter group, combination chemotherapy was reserved for patients with symptomatic extracutaneous disease or disease that was refractory to topical therapies. Patients with any disease stage were eligible. Although the complete response rate was higher with combined therapy, toxic effects were considerably greater, and no difference was seen in disease-free survival (DFS) or OS between the two groups.[4][Level of evidence A1]