Skin / Melanoma
2026-05-22
EORTC Cutaneous Lymphoma RT Recommendations
TL;DRLow-dose RT (8-12 Gy) recommended for indolent cutaneous lymphomas; MF 1-yr local control ≥92%, but no RCT defines a standard dose per entity.
The actionable read is the dose floor: 4 Gy (1-2 fx) underperformed vs 8-12 Gy, so 8-12 Gy stays the low-dose local standard for MF, 24 Gy reserved for large/refractory lesions or pre-autoSCT remission. Low-dose TSEBT trades durability for repeatability and lower toxicity, moving the de-escalation decision in indolent CTCL.
7 details 4 trials watching
EORTC cutaneous lymphoma tumour group expert-opinion / consensus recommendations, synthesizing retrospective case series and limited prospective registries. Proposes a treatment algorithm to standardize radiation dose across EORTC centres.
Modalities span electrons, photons, kilovoltage X-ray, brachytherapy. Low-dose regimens favored for low toxicity and repeatability on relapse; higher-dose TSEBT reserved for remission induction before autologous SCT.
No completed RCTs define the standard dose per entity; recommendations rest on retrospective series and expert consensus. Authors call a prospective trial urgently needed.
| Entity / setting | RT dose |
|---|---|
| MF plaque/tumour (local) | 8-12 Gy / 2-3 fx |
| Low-dose TSEBT (palliative) | 8-12 Gy |
| TSEBT pre-autoSCT | up to 24 Gy |
| Cutaneous DLBCL, leg type | 16-45 Gy (4 Gy/wk to ≤40 Gy) |
In indolent cutaneous lymphoma (MF plaque/tumour, pcALCL, cutaneous B-cell), this supports low-dose RT (8-12 Gy) as effective skin-directed treatment; it does not set a dose for aggressive CTCL variants, where low-dose RT has a limited role.
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