Phototherapy as a First Line Treatment for Mycosis Fungoides: A 10-year Retrospective Study

Alexandra Azevedo; Iolanda Fernandes; Renata Cabral; Margarida Lima; Isabel Amorim; Manuela Selores

doi:10.29021/spdv.77.3.1088

Alexandra Azevedo Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
Iolanda Fernandes Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Multidisciplinary Outpatient Clinic for Cutaneous Lymphomas and Mastocytosis, Centro Hospitalar do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
Renata Cabral Department of Hematology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Multidisciplinary Outpatient Clinic for Cutaneous Lymphomas and Mastocytosis, Centro Hospitalar do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
Margarida Lima Department of Hematology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Multidisciplinary Outpatient Clinic for Cutaneous Lymphomas and Mastocytosis, Centro Hospitalar do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
Isabel Amorim Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
Manuela Selores Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal

DOI: https://doi.org/10.29021/spdv.77.3.1088

Palavras-chave: Fármacos Fotossensibilizantes, Fototerapia, Micose Fungóide/tratamento, Terapia PUVA

Resumo

Introdução: A fototerapia, em particular a fotoquimioterapia com psoralenos associados a radiações ultravioleta do tipo A (PUVA) e a fototerapia com radiações ultravioleta do tipo B de banda estreita (nbUVB), é um dos pilares do tratamento da micose fungóide (MF).

Métodos: Foram analisados os resultados de doentes com MF que fizeram tratamento de primeira linha com PUVA ou nbUVB na Unidade de Fotodermatologia do Serviço de Dermatologia do Centro Hospitalar Universitário do Porto, de 2007 a 2017. O resultado primário foi a resposta ao tratamento. O resultado secundário foi a sobrevida livre de recidiva.

Resultados: De um total de 34 doentes com MF, nove (26,5%) foram diagnosticados no estadio IA e 25 (73,5%) no estadio IB. Destes doentes, 30 (88,2%) foram tratados com PUVA e quatro (11,8%) com nbUVB. Globalmente, 24 (80%) doentes tratados com PUVA e dois (50%) doentes tratados com nbUVB tiveram respostas completas. Foi observada recidiva em 17 (70,8%) doentes tratados com PUVA e em dois (100%) doentes tratados com nbUVB. A mediana da sobrevida livre de recidiva foi de 12 meses para o grupo PUVA e 6 meses para o grupo nbUVB.

Conclusão: A fotoquimioterapia com PUVA é uma terapêutica eficaz na MF em estadios precoces. O UVB de banda estreita pode ser uma alternativa terapêutica válida para estes doentes. Todavia, a amostra reduzida do grupo nbUVB neste estudo limita as conclusões sobre a sua eficácia.

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Fototerapia como Primeira Linha Terapêutica para a Micose Fungóide: Um Estudo Retrospetivo de 10 Anos

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