The Essential Role of Radiotherapy in the Treatment of Merkel Cell Carcinoma: A Study From the Rare Cancer Network

Journal Article · Tue Nov 15 04:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2011.05.028· OSTI ID:22054436

Ghadjar, Pirus ^[1]; Kaanders, Johannes H ^[2]; Poortmans, Philipp ^[3]; Zaucha, Renata ^[4]; Krengli, Marco ^[5]; Lagrange, Jean L ^[6]; Oezsoy, Orhan ^[7]; Nguyen, Tan D ^[8]; Miralbell, Raymond ^[9]; Baize, Adele ^[10]; Boujelbene, Noureddine ^[11]; Collen, Timothy ^[12]; Scandolaro, Luciano ^[13]; Untereiner, Michel ^[14]; Goldberg, Hadassah ^[15]; Pesce, Gianfranco A ^[16]; Anacak, Yavuz ^[17]; Friedrich, Esther E; Aebersold, Daniel M ^[1]; Beer, Karl T ^[18]

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1. Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern (Switzerland)
2. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Institute of Oncology (Netherlands)
3. Department of Radiation Oncology, Institute Verbeeten, Tilburg (Netherlands)
4. Department of Oncology and Radiotherapy, Medical University, Gdansk (Poland)
5. Department of Radiotherapy, University Hospital Maggiore della Carita, Novara (Italy)
6. Service de Radiotherapie, Hopital Henri-Mondor, Creteil (France)
7. Department of Radiation Oncology, CHCVs-RSV, Sion (Switzerland)
8. Department of Radiation Oncology, Institut Jean Godinot, Reims (France)
9. Department of Radiation Oncology, Hopitaux Universitaires de Geneve, Geneva (Switzerland)
10. Department de Radio-Oncologie, Institut Jules Bordet, Bruxelles (Belgium)
11. Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)
12. Department of Radiation Oncology, Kantonsspital St. Gallen (Switzerland)
13. Radioterapia, Azienda Ospedale Sant' Anna, Como (Italy)
14. Centre Francois Baclesse, Luxembourg (Luxembourg)
15. Oncology Departement, Rambam Medical Center, Haifa (Israel)
16. Department of Radiation Oncology, Oncology Institute of Southern Switzerland, Opedale San Giovanni, Bellinzona (Switzerland)
17. Department of Radiation Oncology, EGE University, Izmir (Turkey)
18. Radio Onkologiezentrum Biel (Switzerland)

Purpose: To evaluate the role of postoperative radiotherapy (RT) in Merkel cell carcinoma (MCC). Methods and Materials: A retrospective multicenter study was performed in 180 patients with MCC treated between February 1988 and September 2009. Patients who had had surgery alone were compared with patients who received surgery and postoperative RT or radical RT. Local relapse-free survival (LRFS), regional relapse-free survival (RRFS), and distant metastasis-free survival (DMFS) rates were assessed together with disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates. Results: Seventy-nine patients were male and 101 patients were female, and the median age was 73 years old (range, 38-93 years). The majority of patients had localized disease (n = 146), and the remaining patients had regional lymph node metastasis (n = 34). Forty-nine patients underwent surgery for the primary tumor without postoperative RT to the primary site; the other 131 patients received surgery for the primary tumor, followed by postoperative RT (n = 118) or a biopsy of the primary tumor followed by radical RT (n = 13). Median follow-up was 5 years (range, 0.2-16.5 years). Patients in the RT group had improved LRFS (93% vs. 64%; p < 0.001), RRFS (76% vs. 27%; p < 0.001), DMFS (70% vs. 42%; p = 0.01), DFS (59% vs. 4%; p < 0.001), and CSS (65% vs. 49%; p = 0.03) rates compared to patients who underwent surgery for the primary tumor alone; LRFS, RRFS, DMFS, and DFS rates remained significant with multivariable Cox regression analysis. However OS was not significantly improved by postoperative RT (56% vs. 46%; p = 0.2). Conclusions: After multivariable analysis, postoperative RT was associated with improved outcome and seems to be an important component in the multimodality treatment of MCC.

• OSTI ID: 22054436
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
CARCINOMAS
FEMALES
LYMPH NODES
MALES
METASTASES
PATIENTS
RADIOTHERAPY
REGRESSION ANALYSIS
SURGERY