PD12 Narrowband ultraviolet B and psoralen plus ultraviolet A phototherapy for mycosis fungoides: a 17-year retrospective cohort study in a university teaching hospital (2007–2024)

Abstract Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma (CTCL), with an annual incidence of 0.7 per 100 000 in the UK. Given the chronic and often progressive nature of MF, treatment strategies aim to control symptoms, delay disease progression and improve patients’ quality of life. Narrowband ultraviolet B (NB-UVB) and psoralen plus UVA (PUVA) are widely used in the management of early-stage MF. This study aimed to evaluate the effectiveness of NB-UVB and PUVA in treating MF, to compare response rates across disease stages, and to assess the impact of demographic factors on treatment outcomes. This retrospective cohort study analysed data from patients treated with NB-UVB or PUVA at a university teaching hospital between January 2007 and June 2024. Patients with biopsy-confirmed early-stage MF (IA–IIB) were included. Data were extracted from electronic medical records, including demographics, disease stage, phototherapy type, cumulative dose, response to treatment and duration of remission. Treatment response was categorized as complete (> 95% lesion clearance), partial (50–95%) or nonresponse (< 50%). Statistical analyses, including linear regression and univariate analysis, were performed to assess associations between treatment response and variables such as age, sex and cumulative phototherapy dose. Data were analysed using SPSS version 29. Thirty-two patients met the inclusion criteria (mean age 55.6 years; 50% male). Of these, 25 (78%) were treated with NB-UVB, five (16%) with PUVA and two (6%) with both. Complete remission was achieved in 44% of patients, partial remission in 47% and nonresponse in 9%. Younger age and higher cumulative phototherapy dose were associated with better outcomes, although these were not statistically significant (P = 0.93 and P = 0.08, respectively). Male patients showed better responses than female patients, but this was not significant (P = 0.71). Eleven patients (34%) relapsed, while eight (25%) maintained remission over a total follow-up period of 404 person-months. The median number of sessions required for complete response was 30 (95% confidence interval 28–37), with no significant difference between NB-UVB and PUVA in remission rates. Phototherapy was well tolerated, with minor adverse events in three patients. NB-UVB and PUVA phototherapy are effective in managing early-stage MF, with nearly half of patients achieving complete remission and most showing some degree of response. While younger age, male sex and higher cumulative dose correlated with improved outcomes, these associations were not statistically significant. Further studies with larger cohorts and longer follow-up are needed to refine treatment protocols and optimize patient outcome.