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40

NCCN Guidelines for Patients

®

Mycosis Fungoides, Version 1.2016

3

DCIS

Genetic counseling | Treatment

u

4

Treatment guide

Stage IA treatment

4.1 Stage IA treatment

Switch to second-line treatments if:

• Multiple courses of first-line treatment didn’t work, or

• The cancer is worse and is a higher cancer stage

Chart 4.1.2 Second-line treatments

Options for widespread treatment

• Systemic treatment ± generalized skin treatment:

Systemic treatment

◦◦ Oral retinoids

◦◦ Interferons

◦◦ HDAC-inhibitors

(ie, belinostat,vorinostat, romidepsin)

◦◦ Extracorporeal photopheresis

◦◦ Methotrexate

Generalized skin treatment

◦◦ Topical steroids

◦◦ Topical chemotherapy (ie, mechlorethamine)

◦◦ Phototherapy

◦◦ Total skin electron beam therapy

• Total skin electron beam therapy

• Clinical trial

Start with first-line treatments:

Œ



Chart 4.1.1 First-line treatments

Options for local skin treatments

• Topical steroids

• Topical chemotherapy (ie, mechlorethamine)

• Local radiation therapy

• Topical retinoids (ie, bexarotene, tazarotene)

• Phototherapy

• Topical imiquimod

Try another course of first-

line treatments if:

• Treatment worked at

first but the cancer came

back as stage IA, or

• 1 or 2 treatment options

didn’t work