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

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.