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44

NCCN Guidelines for Patients

®

Mycosis Fungoides, Version 1.2016

3

DCIS

Genetic counseling | Treatment

4

Treatment guide

Stage IIB treatment

4.3 Stage IIB treatment

Start with first-line treatments:

Œ

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 4.3.2 Second-line treatments

Treatment options

• Total skin electron beam therapy

• Systemic treatment ± skin treatment

• Combination treatment

Try another course of

first-line treatments if:

• Treatment worked at

first but the cancer

came back as stage I,

IIA, or limited IIB, or

• Only 1 or 2 treatments

were tried and didn’t

work

Limited skin lesions — Less than 10% of the skin

Chart 4.3.1 First-line treatments

Treatment options

• Local radiation therapy for tumors ± skin treatment

Skin treatment for patches, papules, and plaques

◦◦ Steroids

◦◦ Mechlorethamine

◦◦ Retinoids

◦◦ Phototherapy

◦◦ Imiquimod

• Systemic treatment ± radiation therapy ± skin treatment

Systemic treatment

◦◦ Oral retinoids

◦◦ Interferons

◦◦ HDAC-inhibitors

(ie, belinostat,vorinostat, romidepsin)

◦◦ Extracorporeal photopheresis

◦◦ Methotrexate