Primary cutaneous lymphomas (PCLs), including cutaneous T-cell lymphomas (CTCL) and primary cutaneous B-cell lymphomas (PCBCL), are a diverse group of non-Hodgkin lymphomas that primarily affect the skin. Radiotherapy (RT) plays a pivotal role in the treatment of these lymphomas, particularly for localized disease, due to its ability to deliver precise, skin-directed treatment. Mycosis fungoides (MF) and Sézary syndrome (SS), the most common subtypes of CTCL, often require skin-directed therapies such as electron beam therapy and superficial brachytherapy to manage localized lesions. Electron beam therapy, including total skin electron beam therapy (TSEBT), has been utilized for decades, offering high response rates but with the risk of cumulative skin toxicity. Recently, low-dose radiotherapy (LDRT) has gained attention as an effective alternative that reduces toxicity while maintaining durable responses. Superficial brachytherapy is another modality that delivers radiation through custom molds, allowing for homogeneous dosing over complex anatomical areas like the face. Both teleradiotherapy and brachytherapy have demonstrated high complete response rates, with low recurrence rates observed when higher doses are used. In the context of primary cutaneous B-cell lymphomas, such as primary cutaneous marginal zone lymphoma (PCMZL) and primary cutaneous follicle center lymphoma (PCFCL), radiotherapy also offers excellent local control, particularly for indolent subtypes. However, more aggressive subtypes, such as diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), may require systemic therapies in addition to radiation. Overall, teleradiotherapy and brachytherapy are essential components of the therapeutic arsenal for primary cutaneous lymphomas, offering effective disease control with manageable toxicity, while ongoing research focuses on optimizing treatment strategies and exploring novel combinations with systemic therapies.
原发性皮肤淋巴瘤（PCLs）是一组主要累及皮肤的非霍奇金淋巴瘤，包括皮肤T细胞淋巴瘤（CTCL）和原发性皮肤B细胞淋巴瘤（PCBCL）。放射治疗（RT）因其能够提供精准的皮肤靶向治疗，在PCLs的治疗中发挥着关键作用，尤其适用于局限性病变。蕈样肉芽肿（MF）和Sézary综合征（SS）作为CTCL最常见的亚型，常需采用皮肤靶向治疗，如电子束治疗和浅表近距离放射治疗，以控制局部病灶。电子束治疗，包括全皮肤电子束治疗（TSEBT），已应用数十年，具有高缓解率，但存在累积性皮肤毒性的风险。近年来，低剂量放射治疗（LDRT）作为一种有效替代方案受到关注，可在保持持久疗效的同时降低毒性。浅表近距离放射治疗是另一种通过定制模具施放辐射的治疗方式，可在面部等复杂解剖区域实现均匀剂量分布。无论是远距离放射治疗还是近距离放射治疗，均显示出较高的完全缓解率，且在使用较高剂量时观察到较低的复发率。对于原发性皮肤B细胞淋巴瘤，如原发性皮肤边缘区淋巴瘤（PCMZL）和原发性皮肤滤泡中心淋巴瘤（PCFCL），放射治疗同样能提供优异的局部控制效果，尤其对于惰性亚型。然而，更具侵袭性的亚型，如腿型弥漫性大B细胞淋巴瘤（PCDLBCL-LT），除放疗外可能还需联合全身治疗。总体而言，远距离放射治疗和近距离放射治疗是原发性皮肤淋巴瘤治疗体系中的重要组成部分，能以可管理的毒性实现有效的疾病控制；当前研究重点在于优化治疗策略，并探索其与全身治疗的新型联合方案。
Targeted Radiotherapy in Primary Cutaneous Lymphomas: Precision, Efficacy, and Evolving Strategies
肿瘤(癌症)患者之家