Low-dose total skin electron beam therapy (TSEBT) is an effective treatment option for mycosis fungoides (MF) with proven palliative effects and reduced toxicity. Presented is an institutional analysis of survival/response rate and quality of life for MF patients with subgroup analysis of those possessing pathologic large cell transformation (LCT). This is a single institutional retrospective review of patients with mycosis fungicides treated from 2014 to 2023 with low-dose TSEBT. All patients received 12 Gy in 6 fractions every other day with the modified Stanford technique, with boosts to shadowed sites between treatments, completed in 2 weeks. Outcomes evaluated included clinical response, duration of and time to response, patient-reported quality of life, and physician-scored disease burden. Forty-six patients were included in the study, 28 male and 18 female, with a median age 66.5 (range 32.7–90.6). Stage IB was most common at the time of TSEBT (41.3%). Median follow up was 44.5 months. The overall response rate was 91.3% (52.2% partial response, 19.6% complete and near complete response). The median duration of response was 8.2 months (range, 6.1–28.7), and the median time to best response was 3.5 months (range, 2.7–5.6). Quality of life (QOL) and disease burden continued to show significant benefit after TSEBT (p<0.001). In a subgroup analysis, 18 patients (39.1%) were found to have large cell transformation (LCT) at diagnosis. LCT was associated with higher presenting stage prior to TSEBT (p=0.016) and a better response to treatment (p=0.040). However, median duration of response was only 7.4 months in the patients with LCT vs. 39.4 months in the patients without (p=0.003). Condensed Low-dose TSEBT is a convenient treatment with favorable clinical outcomes and low toxicities in patients with mycosis fungoides. Patients with LCT may have shorter duration of treatment response. Further studies are warranted to validate this finding.

The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assessed circadian timing’s impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. The aim of the study was to evaluate circadian influence on radiation treatment timing and its correlation with clinical outcomes and to identify patient populations benefiting from interventions synchronizing circadian rhythms, considering subgroup differences and potential disparities. An IRB-approved retrospective analysis of 237 patients undergoing whole-brain radiotherapy for brain metastases (2017–2021), receiving over 80% of treatments in the morning or afternoon, was performed. Survival analyses utilized Kaplan–Meier curves. This was a single-institution study involving patients receiving whole-brain radiotherapy. Demographic, disease, and socioeconomic parameters from electronic medical records were collected. Morning treatment (n = 158) showed a trend toward improved overall survival vs. afternoon (n = 79); the median survival was 158 vs. 79 days (p = 0.20, HR = 0.84, CI_95% 0.84–0.91). Subgroup benefits for morning treatment in females (p = 0.04) and trends in controlled primary disease (p = 0.11) and breast cancer metastases (p = 0.08) were observed. Black patients exhibited diminished circadian influence. The present study emphasized chronobiological factors’ relevance in brain metastases radiation therapy. Morning treatment correlated with improved survival, particularly in specific subgroups. Potential circadian influence disparities were identified, laying a foundation for personalized cancer therapy and interventions synchronizing circadian rhythms for enhanced treatment efficacy.

Thermoplastic masks are commonly used in radiation therapy to immobilize a patient's head and neck during treatment. They are primarily composed of non-toxic polyester compounds that can be manipulated with heat to mold the shape of a patient's head and neck. There is little previously reported evidence of these masks causing allergic contact dermatitis. We present a case of a 44-year-old female with a history of squamous cell carcinoma of the right tonsil with multiple enlarged lymph nodes following surgical excision of the right tonsillar mass and ipsilateral neck dissection elected to undergo adjuvant radiation therapy with volumetric modulated arc therapy (VMAT) technique without concurrent chemotherapy. A thermoplastic mask was issued prior to radiation therapy. Following the mask fitting, the patient developed an allergic contact dermatitis reaction of the head and neck in areas covered by the mask. Her symptoms worsened with continued use of the thermoplastic mask and radiation therapy. As the patient continued and eventually finished the radiation treatment regimen, the dermatologic symptoms failed to respond to topical facial moisturizer and steroid treatment. The contact dermatitis reaction did not completely dissipate until about three months following completion of radiation therapy and contact with the thermoplastic mask. Thermoplastic masks are not known to cause an allergic contact dermatitis reaction. There is only one other reported case documented in the literature. Such reactions can alter the course of radiation therapy if symptoms are severe enough to disrupt treatment or if they cause worsening of the radiation dermatitis. Allergic contact dermatitis to thermoplastic masks should be well documented in the future to better understand the cause and possible risk factors related to the reaction.

Background: The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assesses circadian timing's impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. Aim: Evaluate circadian influence on radiation treatment timing and its correlation with clinical outcomes. Identify patient populations benefiting from interventions synchronizing circadian rhythms, considering subgroup differences and potential disparities related to social determinants of health (SDoH). Design: IRB-approved retrospective analysis of 237 patients undergoing whole-brain radiotherapy for brain metastases (2017–2021), receiving over 80% of treatments in the morning or afternoon. Survival analyses utilized Kaplan–Meier curves. Setting/Participants: Single-institution study involving patients receiving whole-brain radiotherapy. Collected demographic, disease, and socioeconomic parameters from electronic medical records. Results: Morning treatment (n=158) showed a trend towards improved overall survival vs. afternoon (n=79), median survival 158 vs. 79 days (p=0.20, HR=0.84, CI95% 0.84–0.91). Subgroup benefits for morning treatment in females (p=0.04) and trends in controlled primary disease (p=0.11) and breast cancer metastases (p=0.08). SDoH-based disparities observed, with Black and lower-income patients exhibiting diminished circadian influence. Conclusions: Emphasizes chronobiological factors' relevance in brain metastases radiation therapy. Morning treatment correlates with improved survival, particularly in specific subgroups. Identifies potential circadian influence disparities based on SDoH, laying a foundation for personalized cancer therapy and interventions synchronizing circadian rhythms for enhanced treatment efficacy.