Main Session
Sep
28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology
2780 - Patient-Reported Outcomes during Radiotherapy for Mycosis Fungoides and Other Cutaneous Lymphomas
Presenter(s)
Kaitlyn Lapen, MD - Memorial Sloan Kettering Cancer Center, New York, NY
K. Lapen1, B. Fregonese1, B. King1, A. Torres1, V. Liao2, A. J. Moskowitz3, Z. Epstein-Peterson3, R. Stuver3, S. Horwitz3, N. P. Mankuzhy1, R. R. Patel1, A. Deshane1, A. Dreyfuss4, G. Cederquist1, Z. R. Moore1, S. Geller2, J. Yahalom1, and B. S. Imber1; 1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, 2Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 3Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 4Department of Radiation Oncology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL
Purpose/Objective(s):
Radiotherapy (RT) effectively reduces disease burden and alleviates symptoms in cutaneous lymphomas, yet patient-reported outcomes (PRO) assessing symptom burden, treatment toxicity, and quality of life (QOL) are not routinely captured. We developed and implemented a PRO assessment to evaluate patient experience during and after RT for mycosis fungoides (MF) and other cutaneous lymphomas.Materials/Methods:
A 30-item PRO assessment combined Skindex-16 (S16) with selected PRO-CTCAE and EORTC QLQ-C30 items. The tool was integrated into routine care at two hematologic radiation oncology clinics and administered at consultation, weekly during RT, and monthly after RT via paper or REDCap. S16 scores (range 0–100, higher scores indicating worse QOL) were analyzed using Wilcoxon rank-sum tests; A =10-point change was considered clinically meaningful.Results:
Between 11/2024-8/2025, 63 patients completed PRO assessments across 75 RT courses, yielding 248 assessments (47% response rate). Median age was 60 years (IQR: 47–70). Most had MF (n=41; 65%) or cutaneous indolent B-cell lymphoma (n=12; 19%). RT modalities included total skin electron beam therapy (TSEBT) in 36% of courses (n=27) and focal RT in 64% (n=48) The most common dose-fractionation regimen was 12 Gy in 6 fractions, delivered in 17 TSEBT courses and 15 focal RT courses. Median baseline S16 was 46.8 (IQR: 24.6–64.7). Baseline scores were higher in MF compared to other histologies (51.1 vs. 29.4; p=0.005) but similar between those treated with TSEBT or focal RT (52.1 vs. 42.9; p=0.147). Clinically meaningful improvements emerged by one month and were sustained through six months post-RT, with median S16 scores of 19.6 (IQR 7.9–39.9), 25.0 (IQR 7.7–35.9), and 30.2 (IQR 6.8–34.7) at one, three, and six months, respectively. Improvements were greater with TSEBT; At one month, S16 scores declined 69% after TSEBT (from 52.1 to 16.5) versus 48% after focal RT (from 42.9 to 22.4). S16 subscale analysis demonstrated improvement across all domains. Median baseline symptom, emotional, and functional scores were 37.5 (IQR: 24.0–56.3), 66.7 (IQR: 39.9–83.3), and 30.0 (IQR: 9.2–53.3), improving to 14.6 (IQR: 5.2–38.5), 34.5 (IQR: 10.7–58.3), and 8.3 (IQR: 0.0–32.5) at one month. During RT, moderate-to-very severe fatigue, skin dryness, insomnia, and skin burns were reported in 59%, 52%, 41%, and 25% of patients, declining to 36%, 36%, 33%, and 19% by one month post-RT.Conclusion:
PRO collection during RT for cutaneous lymphoma is feasible and demonstrates clinically meaningful, sustained improvements in symptoms, emotional well-being, and function. Both TSEBT and focal RT reduced symptom burden, with greater improvement after TSEBT. Toxicities were common during RT but improved post-treatment, supporting the therapeutic and palliative benefit of RT and integration of PRO monitoring into routine care.