The importance of postoperative radiation therapy in the treatment of Merkel cell carcinoma

Meeuwissen, J.A.C.; Bourne, Robert G.; Kearsley, John H.

doi:10.1016/0360-3016(94)e0145-a

Cited by 243 publications

(232 citation statements)

References 19 publications

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“…Meeuwissen et al 3 15 Eleven (21%) of 53 patients suffered locoregional failure, and the 3-year actuarial locoregional control was 75%. In a review of the literature, Haag et al 16 reported that local recurrence developed in 26% to 44% of patients, and during the course of the disease, 55% to 66% of patients developed regional node metastases.…”

Section: Discussionmentioning

confidence: 97%

“…Prognostic factors have been well described in previous reports [3][4][5][6][7][8][9][10][11][12] and a recent review by Goessling et al 13 summarizes these. In comparing these results with those reported in the literature, it is important to match the proportion of patients with adverse prognostic variables, the most important being the presence of nodal metastases.…”

Section: Discussionmentioning

confidence: 98%

“…In comparing these results with those reported in the literature, it is important to match the proportion of patients with adverse prognostic variables, the most important being the presence of nodal metastases. [3][4][5][6][7] Thirty-three patients (62%) registered on this study had involved nodes (stage II) at presentation. This contrasts with the literature where the reported incidence of nodes at presentation varied from 9% to 33%, [3][4][5][8][9][10][11] and confirms the particularly poor prognostic profile of patients in this trial (being at high risk of disseminated disease).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence varies from 0% to 18%, 3,4,8,15 and can be attributed to spontaneous regression of the primary 18 or metastatic neuroendocrine carcinoma from a noncutaneous site. The incidence in this series was proportionally higher (25%) and may be as a result of several factors.…”

Section: Discussionmentioning

confidence: 99%

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High-Risk Merkel Cell Carcinoma of the Skin Treated With Synchronous Carboplatin/Etoposide and Radiation: A Trans-Tasman Radiation Oncology Group Study—TROG 96:07

Poulsen

Rischin

Walpole

et al. 2003

JCO

200

115

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Purpose: The effectiveness of synchronous carboplatin, etoposide, and radiation therapy was prospectively assessed in a group of patients with high-risk Merkel cell carcinoma (MCC) of the skin.Patients and Methods: Patients were eligible if they had disease localized to the primary site and nodes, and were required to have at least one of the following high risk features: recurrence after initial therapy, involved nodes, primary tumor size greater than 1 cm, gross residual disease after surgery, or occult primary with nodes. Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks and synchronous carboplatin (area under the curve, 4.5) and intravenous etoposide 80 mg/m 2 days 1 to 3 was given in weeks 1, 4, 7, and 10. The median age of the group was 67 (range, 43-86) years, and there were 39 males and 14 females. Involved nodes (stage II) were present in 33 cases (62%). The sites involved were head and neck (22 patients), occult primary (13 patients), upper limb (eight patients), lower limb (eight patients), and trunk (two patients).Results: Fifty-three patients were entered between 1996 and 2001. The median potential follow-up was 48 months. There were no treatment related deaths. The 3-year overall survival, locoregional control, and distant control were 76%, 75%, and 76%, respectively. Tumor site and the presence of nodes were factors that were predictive for local control and survival. Multivariate analysis indicated that the major factor influencing survival was the presence of nodes; however, this was not a significant factor in locoregional control.Conclusion: High levels of locoregional control and survival have been achieved with the addition of chemotherapy to radiation treatment for high-risk MCC of the skin. The role of chemoradiotherapy for high-risk MCC warrants further investigation.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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High-Risk Merkel Cell Carcinoma of the Skin Treated With Synchronous Carboplatin/Etoposide and Radiation: A Trans-Tasman Radiation Oncology Group Study—TROG 96:07

Poulsen

Rischin

Walpole

et al. 2003

JCO

200

115

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“…Patients present with lymph node disease in 19% to 33% 9,13,[16][17][18] of cases. Traditional recommended practice for the regional therapy for lymph node-positive disease is completion lymphadenectomy (CLND) with or without adjuvant radiotherapy.…”

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confidence: 99%

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Fang

Lemos

Douglas

et al. 2010

Cancer

145

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BACKGROUND:Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with a high risk of lymph node involvement. To the authors' knowledge, few data have been published to date regarding the optimal regional therapy for lymph node‐positive patients. This cohort study was performed to analyze the outcomes of patients with lymph node‐positive MCC treated with lymph node irradiation as definitive therapy compared with completion lymphadenectomy (CLND).METHODS:Fifty patients with lymph node involvement of MCC at presentation and adequate follow‐up data were included in this analysis. Forty‐three of these patients were enrolled and followed prospectively. Twenty‐six patients presented with microscopic lymph node disease, and 24 patients presented with palpable lymph node involvement.RESULTS:Regional control for patients with microscopically involved lymph nodes was 100% regardless of treatment modality—definitive lymph node irradiation (n = 19) or CLND ± radiotherapy (n = 7) with median follow‐up of 18 months. Patients with clinically positive lymph nodes had 2‐year regional recurrence‐free survival rate of 78% and 73% in the definitive lymph node irradiation (n = 9) and CLND ± radiotherapy (n = 15) groups, respectively (P = .8) with a median follow‐up of 16 months.CONCLUSIONS:To the best of the authors' knowledge, the current study is the largest series published to date of radiation monotherapy as regional treatment for lymph node‐positive MCC. Lymph node irradiation alone to positive regional lymph nodes was found to confer an excellent regional control rate that was comparable to CLND for both microscopic and palpable lymph node disease. There was no difference noted with regard to overall survival. Given their similar efficacy, the choice between these lymph node therapies may be based on the clinical scenario and anticipated side effect profiles. Cancer 2010. © 2010 American Cancer Society.

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Merkel Cell Carcinoma Treatment With Radiation

Longo¹,

Nghiem

2003

Arch Dermatol

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The importance of postoperative radiation therapy in the treatment of Merkel cell carcinoma

Cited by 243 publications

References 19 publications

High-Risk Merkel Cell Carcinoma of the Skin Treated With Synchronous Carboplatin/Etoposide and Radiation: A Trans-Tasman Radiation Oncology Group Study—TROG 96:07

High-Risk Merkel Cell Carcinoma of the Skin Treated With Synchronous Carboplatin/Etoposide and Radiation: A Trans-Tasman Radiation Oncology Group Study—TROG 96:07

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Merkel Cell Carcinoma Treatment With Radiation

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