Dakshika A Gunaratne1, Julie R Howle2, Michael J Veness3. 1. Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, Australia. 2. Department of Surgery, Westmead Hospital, Sydney, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, Australia; University of Sydney, Sydney, Australia. 3. Crown Princess Mary Cancer Centre, Westmead Hospital, Australia; University of Sydney, Sydney, Australia; Department of Radiation Oncology, Westmead Hospital, Sydney, Australia. Electronic address: michael.veness@health.nsw.gov.au.
Abstract
BACKGROUND: Merkel cell carcinoma (MCC) is an uncommon radiosensitive, neuroendocrine malignancy. Treatment often involves surgery; however, older, sicker patients may not be candidates for an operation. Institutions have published data favoring the role of definitive radiotherapy for macroscopic locoregional disease. OBJECTIVE: Our objective was to report the outcome of patients treated with definitive radiotherapy. METHODS: We performed a systematic review of Medline, PubMed, and Embase databases for reported cases or series of definitive radiotherapy for macroscopic locoregional MCC. RESULTS: The mean radiation dose did not significantly differ between primary and regional sites (48.7 ± 13.2 vs 49.4 ± 10.1 Gy, P = .74). The rate of recurrence was calculated on the basis of the site of disease (11.7%) and per patient (14.3%). Recurrence was significantly more likely to occur at regional than at primary irradiated sites (16.3% vs 7.6%, P = .02). There was no association between radiotherapy dose and incidence of recurrence or nonrecurrence; primary (42.7 ± 23 vs 49.3 ± 11.8 Gy, P = .197) and regional (48.6 ± 10 vs 49.5 ± 10.3 Gy, P = .77). LIMITATIONS: A limitation of this report is that most publications were retrospective; heterogeneity was present in the size of MCC and in radiotherapy details. CONCLUSIONS: Definitive radiotherapy for locoregional macroscopic MCC was found to confer clinically meaningful local and regional in-field control.
BACKGROUND:Merkel cell carcinoma (MCC) is an uncommon radiosensitive, neuroendocrine malignancy. Treatment often involves surgery; however, older, sicker patients may not be candidates for an operation. Institutions have published data favoring the role of definitive radiotherapy for macroscopic locoregional disease. OBJECTIVE: Our objective was to report the outcome of patients treated with definitive radiotherapy. METHODS: We performed a systematic review of Medline, PubMed, and Embase databases for reported cases or series of definitive radiotherapy for macroscopic locoregional MCC. RESULTS: The mean radiation dose did not significantly differ between primary and regional sites (48.7 ± 13.2 vs 49.4 ± 10.1 Gy, P = .74). The rate of recurrence was calculated on the basis of the site of disease (11.7%) and per patient (14.3%). Recurrence was significantly more likely to occur at regional than at primary irradiated sites (16.3% vs 7.6%, P = .02). There was no association between radiotherapy dose and incidence of recurrence or nonrecurrence; primary (42.7 ± 23 vs 49.3 ± 11.8 Gy, P = .197) and regional (48.6 ± 10 vs 49.5 ± 10.3 Gy, P = .77). LIMITATIONS: A limitation of this report is that most publications were retrospective; heterogeneity was present in the size of MCC and in radiotherapy details. CONCLUSIONS: Definitive radiotherapy for locoregional macroscopic MCC was found to confer clinically meaningful local and regional in-field control.
Authors: M K Ramirez-Fort; B Meier-Schiesser; K Lachance; S S Mahase; C D Church; M J Niaz; H Liu; V Navarro; A Nikolopoulou; D V Kazakov; E Contassot; D P Nguyen; J Sach; L Hadravsky; Y Sheng; S T Tagawa; X Wu; C S Lange; L E French; P T Nghiem; N H Bander Journal: Skin Health Dis Date: 2020-11-28
Authors: Ellen M Zwijnenburg; Satish F K Lubeek; Johanna E M Werner; Avital L Amir; Willem L J Weijs; Robert P Takes; Sjoert A H Pegge; Carla M L van Herpen; Gosse J Adema; Johannes H A M Kaanders Journal: Cancers (Basel) Date: 2021-03-31 Impact factor: 6.639