Dario Zerini1, Filippo Patti1,2, Francesca Spada3, Nicola Fazio3, Eleonora Pisa4, Elisabetta Pennacchioli5, Pierpaolo Prestianni5, Raffaella Cambria6, Matteo Pepa1, Chiara Maria Grana7, Guido Bonomo8, Luigi Funicelli8, Barbara Alicja Jereczek-Fossa1,2, Roberto Orecchia9. 1. Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy. 2. Division of Oncology and Hemato-oncology, University of Milan, Milan, Italy. 3. Division of Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy. 4. Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy. 5. Division of Melanoma, Soft Tissue Sarcomas and Rare Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy. 6. Division of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy. 7. Division of Nuclear Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy. 8. Division of Medical Imaging and Radiation Sciences, IEO, European Institute of Oncology IRCCS Milan, Italy. 9. Scientific Directorate, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Abstract
OBJECTIVE: To review the therapeutic strategy in Merkel cell carcinoma (MCC) treated with radiotherapy (RT) discussed in a multidisciplinary tumour board. METHODS: Clinical records of patients with a diagnosis of MCC and with an indication to undergo RT at the European Institute of Oncology between 2003 and 2018 were reviewed retrospectively. RESULTS: Twenty-six patients were included in the analysis (median age 65 years, range 42-87). Nineteen received adjuvant RT, 4 exclusive RT, and the remainder palliative RT. Intensity-modulated RT was used in 13 cases, a 3D conformal technique in 11 cases, and stereotactic RT in 2 cases. No major toxicities were recorded. The median relapse-free survival (RFS) after adjuvant RT was 20.5 months, while for unknown primary MCC, it was 23 months. In the adjuvant setting, median polyomavirus-positive RFS was 21.5 months (range 1-49) and median polyomavirus-negative RFS was only 14 months (range 4-45). Overall, RFS of polyomavirus-positive and polyomavirus-negative patients was 10.5 and 8 months, respectively. After adjuvant RT, only 1 out of 10 patients had a recurrence in the RT field. At the time of data collection, 16 patients were alive with no evidence of disease, 1 patient was alive with advanced status of disease, 8 patients died of disease progression, and 1 patient died of other causes. CONCLUSIONS: The management of unknown primary and polyomavirus-positive cases, which had a better prognosis in our series, may benefit from a multidisciplinary approach, given the limited data available regarding optimal treatment.
OBJECTIVE: To review the therapeutic strategy in Merkel cell carcinoma (MCC) treated with radiotherapy (RT) discussed in a multidisciplinary tumour board. METHODS: Clinical records of patients with a diagnosis of MCC and with an indication to undergo RT at the European Institute of Oncology between 2003 and 2018 were reviewed retrospectively. RESULTS: Twenty-six patients were included in the analysis (median age 65 years, range 42-87). Nineteen received adjuvant RT, 4 exclusive RT, and the remainder palliative RT. Intensity-modulated RT was used in 13 cases, a 3D conformal technique in 11 cases, and stereotactic RT in 2 cases. No major toxicities were recorded. The median relapse-free survival (RFS) after adjuvant RT was 20.5 months, while for unknown primary MCC, it was 23 months. In the adjuvant setting, median polyomavirus-positive RFS was 21.5 months (range 1-49) and median polyomavirus-negative RFS was only 14 months (range 4-45). Overall, RFS of polyomavirus-positive and polyomavirus-negative patients was 10.5 and 8 months, respectively. After adjuvant RT, only 1 out of 10 patients had a recurrence in the RT field. At the time of data collection, 16 patients were alive with no evidence of disease, 1 patient was alive with advanced status of disease, 8 patients died of disease progression, and 1 patient died of other causes. CONCLUSIONS: The management of unknown primary and polyomavirus-positive cases, which had a better prognosis in our series, may benefit from a multidisciplinary approach, given the limited data available regarding optimal treatment.
Authors: Francesca Spada; Paolo Bossi; Corrado Caracò; Vanna Chiarion Sileni; Angelo Paolo Dei Tos; Nicola Fazio; Giovanni Grignani; Michele Maio; Pietro Quaglino; Paola Queirolo; Paolo Antonio Ascierto Journal: J Immunother Cancer Date: 2022-06 Impact factor: 12.469