Get access

The important role of radiation treatment in the management of Merkel cell carcinoma

Authors

  • G. Hruby,

    1. Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia
    2. Discipline of Medicine, The University of Sydney, Sydney, NSW, Australia
    Search for more papers by this author
  • R.A. Scolyer,

    1. Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia
    2. Discipline of Pathology, The University of Sydney, Sydney, NSW, Australia
    3. Melanoma Institute Australia (formerly the Sydney Melanoma Unit), NSW, Australia
    Search for more papers by this author
  • J.F. Thompson

    Corresponding author
    1. Melanoma Institute Australia (formerly the Sydney Melanoma Unit), NSW, Australia
    2. Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia
    3. Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia
    Search for more papers by this author

  • Funding sources None.
  • Conflicts of interest None declared.

Summary

Merkel cell carcinoma is an aggressive, radiosensitive cutaneous neuroendocrine tumour. In this review, the roles of radiation therapy and chemoradiation in the management of Merkel cell carcinoma are described and discussed, and guidelines for patient management are presented. Radiation treatment may be indicated for definitive (> 55 Gy) or adjuvant (> 50 Gy) treatment of the primary tumour site and for prophylactic (> 50 Gy), adjuvant (> 50 Gy) or definitive (> 55 Gy) treatment of the regional lymph node field. If a patient presents with positive margins after initial biopsy or resection, definitive radiation therapy or chemoradiation may be an alternative to further surgery and, importantly, results in less delay than re-resection followed by adjuvant radiation treatment. Given the rarity of this tumour, patients should be enrolled on prospective databases and clinical trials, and managed in a multidisciplinary clinical setting wherever possible.

Ancillary