Efficacy of narrowband UVB vs. PUVA in patients with early‐stage mycosis fungoides

Introduction Mycosis fungoides (MF) is a non‐Hodgkin’s T‐cell lymphoma of the skin that often begins as limited patches and plaques with slow progression to systemic involvement. Narrowband ultraviolet (UV) B therapy has been proven to be an effective short‐term treatment modality for clearing patch‐stage MF. The effect of psoralen plus long‐wave ultraviolet A (PUVA) in the treatment of patch‐ and plaque‐type MF has also been thoroughly documented. Objectives The purpose of this study was to compare the efficacy and safety of narrowband UVB and PUVA in patients with early‐stage MF. Methods We analysed the response to treatment, relapse‐free survival and irradiation dose in 114 patients with histologically confirmed early‐stage MF (stage IA, IB and IIA). Results A total of 95 patients were treated with PUVA (83.3%) and 19 with narrowband UVB (16.7%). With PUVA, 59 patients (62.1%) had a complete response (CR), 24 (25.3%) had a partial response (PR) and 12 (12.6%) had a failed response. Narrowband UVB led to CR in 12 (68.4%) patients, PR in 5 (26.3%) patients and a failed response in 1 (5.3%) patient. There were no differences in terms of time to relapse between patients treated with PUVA and those treated with narrowband UVB (11.5 vs. 14.0 months respectively; P = 0.816). No major adverse reactions were attributed to the treatment. Conclusions Our results confirm that phototherapy is a safe, effective and well‐tolerated, first‐line therapy in patients with early‐stage cutaneous T‐cell lymphoma, with prolonged disease‐free remissions being achieved. It suggests that narrowband UVB is at least as effective as PUVA for treatment of early‐stage MF.