Selective radiotherapy for the treatment of head and neck Merkel cell carcinoma
Article first published online: 16 DEC 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 16, pages 3937–3944, 15 August 2012
How to Cite
Lok, B., Khan, S., Mutter, R., Liu, J., Fields, R., Pulitzer, M., Shi, W., Zhang, Z., Kraus, D., Pfister, D., Busam, K. J., Brownell, I. and Lee, N. (2012), Selective radiotherapy for the treatment of head and neck Merkel cell carcinoma. Cancer, 118: 3937–3944. doi: 10.1002/cncr.26738
- Issue published online: 3 AUG 2012
- Article first published online: 16 DEC 2011
- Manuscript Accepted: 2 NOV 2011
- Manuscript Revised: 25 OCT 2011
- Manuscript Received: 6 SEP 2011
- Merkel cell;
- head and neck;
The role of radiotherapy (RT) in the management of Merkel cell carcinoma (MCC) is controversial. The authors of this report evaluated the rates and patterns of failure in a selected group of patients who underwent RT for MCC of the head and neck (HN).
The records of 145 consecutive patients with MCC of the HN who presented to the authors' institution between 1988 and 2009 were reviewed. Only patients who received RT at the institution were included. The cumulative incidence of locoregional failure (LRF), distant metastatic failure (DMF), disease progression (DP) and disease-specific death (DSD) were estimated with death as a competing risk.
Forty-eight patients were identified. The median follow-up was 51 months (range, 6-220 months) for living patients. LRF developed in 5 patients (10%), and those patients had a median time to recurrence of 3 months. Two of the 5 LRFs were local and developed at the edge of the treatment field; the remaining 3 LRFs were in lymph nodes and occurred outside the treatment field. DMF developed in 12 patients (25%). The estimated 5-year cumulative incidences of LRF, DP, and DSD were 10%, 30%, and 21%, respectively. Acute toxicities included 5 episodes (10%) of grade 3 dermatitis and 1 episode (2%) of grade 3 mucositis.
The authors report a site-specific series of patients with HN MCC who received RT. In this group of patients with adverse features, RT was well tolerated, and LRF was low. The propensity for MCC to recur at the edge of the treatment field suggests that generous margins are appropriate when RT is administered. Cancer 2012. © 2011 American Cancer Society.