Michael Veness1, Julie Howle. 1. Department of Radiation Oncology, Westmead Cancer Care Centre, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES: To review the role of radiotherapy as treatment (RTx) alone in patients with Merkel cell carcinoma (MCC). METHODS: Data on 41 patients with MCC treated with RTx alone between 1993 and 2013 at Westmead Hospital, Sydney, were reviewed and analysed. RESULTS: The patients' median age was 80 (range 45-96 years) among 18 (44%) women and 23 (56%) men. All but one patient were white and six (15%) were immunosuppressed. Most (59%) were irradiated at initial diagnosis with the remainder treated in the relapse setting. The median duration of follow up was 39 months. Head and neck was the most frequently treated site (63%). The median lesion size was 30 mm (range 5-130 mm). The in-field control rate was 85%. Most out-of-field relapses were to visceral organs. Overall survival at 5 years was 40%. CONCLUSIONS: Patients with MCC treated with RTx alone experience a high likelihood of obtaining in-field disease control. Doses of 50-55 Gy in 20-25 fractions are recommended but lower doses (25 Gy in five fractions) are still effective. A minority will be cured with many patients subsequently dying of systemic relapse.
OBJECTIVES: To review the role of radiotherapy as treatment (RTx) alone in patients with Merkel cell carcinoma (MCC). METHODS: Data on 41 patients with MCC treated with RTx alone between 1993 and 2013 at Westmead Hospital, Sydney, were reviewed and analysed. RESULTS: The patients' median age was 80 (range 45-96 years) among 18 (44%) women and 23 (56%) men. All but one patient were white and six (15%) were immunosuppressed. Most (59%) were irradiated at initial diagnosis with the remainder treated in the relapse setting. The median duration of follow up was 39 months. Head and neck was the most frequently treated site (63%). The median lesion size was 30 mm (range 5-130 mm). The in-field control rate was 85%. Most out-of-field relapses were to visceral organs. Overall survival at 5 years was 40%. CONCLUSIONS:Patients with MCC treated with RTx alone experience a high likelihood of obtaining in-field disease control. Doses of 50-55 Gy in 20-25 fractions are recommended but lower doses (25 Gy in five fractions) are still effective. A minority will be cured with many patients subsequently dying of systemic relapse.
Authors: Jürgen C Becker; Andreas Stang; James A DeCaprio; Lorenzo Cerroni; Celeste Lebbé; Michael Veness; Paul Nghiem Journal: Nat Rev Dis Primers Date: 2017-10-26 Impact factor: 52.329
Authors: Urs Dietmar Achim Müller-Richter; Anja Gesierich; Alexander Christian Kübler; Stefan Hartmann; Roman Camillus Brands Journal: Ann Surg Oncol Date: 2017-07-31 Impact factor: 5.344
Authors: David L Kok; Annie Wang; Wen Xu; Margaret S T Chua; Alexander Guminski; Michael Veness; Julie Howle; Richard Tothill; Ganessan Kichendasse; Michael Poulsen; Shahneen Sandhu; Gerald Fogarty Journal: Asia Pac J Clin Oncol Date: 2020-08-05 Impact factor: 2.601