A Retrospective Comparison Between Home and in‐Office NB‐UVB Efficacy for Patients With Mycosis Fungoides

• Published in: Photodermatology, photoimmunology & photomedicine Vol. 40; no. 6; pp. e13009 - n/a
• Main Authors: Garfinkel, Victoria, Reisch, Joan S., Goff, Heather Woodworth
• Format: Journal Article
• Language: English
• Published: 01-11-2024
• Subjects: efficacy; home‐based narrowband ultraviolet B phototherapy; mycosis Fungoides
• ISSN: 0905-4383; 1600-0781; 1600-0781
• DOI: 10.1111/phpp.13009

ABSTRACT
Introduction
This study addresses the gap in research comparing the effectiveness between home and in‐office narrowband ultraviolet B (NB‐UVB) phototherapy for the treatment of mycosis fungoides (MF). Elderly and disabled patients with this condition disproportionally lack access to home units due to insurance denial.
Materials and Methods
A retrospective review included patients diagnosed with MF or Sezary syndrome who underwent either in‐office or home UVB between 2016 and 2023. Eighty‐four patients used home NB‐UVB, while 75 used in‐office. Clinical characteristics, treatment response, and access were evaluated.
Results
Overall, there was no significant difference in response rates between home and in‐office NB‐UVB phototherapy. Subgroup analysis based on adjuvant treatment revealed a significant difference in clinical response rates for patients using NB‐UVB with topicals (p = 0.008) and NB‐UVB with multiple systemic therapies (p = 0.04). Financial and time constraints were the most common cause of treatment discontinuation for in‐office patients (28%).
Conclusions
The effectiveness of home NB‐UVB treatment is comparable, if not superior, to in‐office treatment, likely attributed to treatment ease in access and compliance. Medicare and other health insurance companies should expand coverage to include home‐based phototherapy for patients with MF, a potentially fatal cancer with a relative paucity of effective alternate therapies.