Definitive radiotherapy for Merkel cell carcinoma confers clinically meaningful in-field locoregional control: A review and analysis of the literature

Publication date: Available online 9 May 2017
Source:Journal of the American Academy of Dermatology
Author(s): Dakshika A. Gunaratne, Julie R. Howle, Michael J. Veness
BackgroundMerkel 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.ObjectiveOur objective was to report the outcome of patients treated with definitive radiotherapy.MethodsWe performed a systematic review of Medline, PubMed, and Embase databases for reported cases or series of definitive radiotherapy for macroscopic locoregional MCC.ResultsThe 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).LimitationsA limitation of this report is that most publications were retrospective; heterogeneity was present in the size of MCC and in radiotherapy details.ConclusionsDefinitive radiotherapy for locoregional macroscopic MCC was found to confer clinically meaningful local and regional in-field control.



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