Journal ArticleDOI
Definitive radiotherapy for Merkel cell carcinoma confers clinically meaningful in-field locoregional control: A review and analysis of the literature.
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TLDR
Definitive radiotherapy for locoregional macroscopic MCC was found to confer clinically meaningful local and regional in‐field control.Abstract:
Background Merkel 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. Objective Our objective was to report the outcome of patients treated with definitive radiotherapy. Methods We performed a systematic review of Medline, PubMed, and Embase databases for reported cases or series of definitive radiotherapy for macroscopic locoregional MCC. Results The 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). Limitations A limitation of this report is that most publications were retrospective; heterogeneity was present in the size of MCC and in radiotherapy details. Conclusions Definitive radiotherapy for locoregional macroscopic MCC was found to confer clinically meaningful local and regional in-field control.read more
Citations
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Journal ArticleDOI
Merkel cell carcinoma.
Jürgen C. Becker,Andreas Stang,James A. DeCaprio,Lorenzo Cerroni,Céleste Lebbé,Michael J. Veness,Paul Nghiem +6 more
TL;DR: Excision of the tumour is the first-line therapy; if not feasible, radiotherapy can often effectively control the disease, and Chemotherapy was the only alternative in advanced-stage or refractory MCC until several clinical trials demonstrated the efficacy of immune-checkpoint inhibitors.
Journal ArticleDOI
Merkel cell carcinoma: Epidemiology, pathogenesis, diagnosis and therapy
TL;DR: There are no biomarkers predictive of response that could help to better select patients to these new therapies, and additional research is essential.
Journal ArticleDOI
The role of radiotherapy in the management of non-melanoma skin cancer.
TL;DR: This work aims to present an update for clinicians that manage patients with non‐melanoma skin cancer on the role of radiotherapy, and suggests elderly and co‐morbid patients with poor performance status can benefit from short‐course hypofractionated radiotherapy in the setting where surgery is not an option.
Journal ArticleDOI
Advances in Immunotherapy for Metastatic Merkel Cell Carcinoma: A Clinician's Guide
TL;DR: PD-1 axis checkpoint inhibitors are now regarded as the preferred frontline systemic therapy in eligible patients (including both VP- and VN-MCC), with impressive frequency, durability, and depth of objective responses, which compare favorably to those of most solid tumors.
Journal ArticleDOI
Updates on Merkel Cell Carcinoma.
Drew A. Emge,Adela R. Cardones +1 more
TL;DR: Surgical excision with margins of 1 to 2 cm remains first-line therapy for early-stage MCC, but robust evidence supporting immunotherapy for patients with advanced disease has led to recent approval of immune checkpoint inhibitors in the treatment of advanced MCC.
References
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Journal ArticleDOI
The importance of postoperative radiation therapy in the treatment of Merkel cell carcinoma
TL;DR: A large series of reports confirms earlier reports from this Institute and highlights the importance of S + RT over S alone in preventing local recurrence of this highly malignant skin cancer.
Journal ArticleDOI
Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.
Christopher K. Bichakjian,Thomas Olencki,Sumaira Z. Aasi,Murad Alam,James S. Andersen,Rachel C. Blitzblau,Glen M. Bowen,Carlo M. Contreras,Gregory A. Daniels,Roy H. Decker,Jeffrey M. Farma,Kris Fisher,Brian R. Gastman,Karthik Ghosh,Roy C. Grekin,Kenneth Grossman,Alan L. Ho,Karl D. Lewis,Manisha J. Loss,Daniel D. Lydiatt,Jane L. Messina,Kishwer S. Nehal,Paul Nghiem,Igor Puzanov,Chrysalyne D. Schmults,Ashok R. Shaha,Valencia Thomas,Yaohui G. Xu,John A. Zic,Karin G. Hoffmann,Anita M. Engh +30 more
TL;DR: This selection from the NCCN Guidelines for Merkel Cell Carcinoma focuses on areas impacted by recently emerging data, including sections describing MCC risk factors, diagnosis, workup, follow-up, and management of advanced disease with radiation and systemic therapy.
Journal ArticleDOI
The essential role of radiation therapy in securing locoregional control of merkel cell carcinoma
William H. Morrison,Lester J. Peters,Elvio G. Silva,Charles D. Wendt,K. Kian Ang,Helmuth Goepfert +5 more
TL;DR: Between 1966 and 1987, 54 patients with non-disseminated Merkel cell carcinoma (MCC) were treated with curative intent at the University of Texas M. D. Anderson Cancer Center, and the current recommendation for initial treatment is excision of the primary tumor followed by irradiation with generous fields to include the primary tumors.
Journal ArticleDOI
Further insights into the natural history and management of primary cutaneous neuroendocrine (merkel cell) carcinoma
TL;DR: In this poor prognosis tumor, further investigation of adjuvant radiotherapy and chemotherapy is warranted, as responsiveness of recurrent disease is confirmed.
Journal ArticleDOI
Clinical Radiation Sensitivity With DNA Repair Disorders: An Overview
TL;DR: The findings support previous wisdom that radiotherapy should either be avoided or the doses should be selected with great care in the case of these radiosensitive genotypes, which must be recognized by their characteristic phenotypes, until more rapid, reliable, and functional assays of DNA repair become available.
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