Outcome of early stage Merkel carcinoma treated by exclusive radiation: a study of 53 patients
Autor: | M. Dubois, Xavier Mirabel, Laurent Mortier, Véronique Dziwniel, Alexandre Escande, F. Dezoteux, Maeva Kyheng, Julien Labreuche, F. Darloy, Henry Abi Rached, Anaïs Jouin |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Oncology
Male medicine.medical_specialty Skin Neoplasms medicine.medical_treatment R895-920 030207 dermatology & venereal diseases 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Merkel cell carcinoma Internal medicine medicine Carcinoma Skin cancer Humans Radiology Nuclear Medicine and imaging Stage (cooking) RC254-282 Aged Retrospective Studies Aged 80 and over Proportional hazards model business.industry Research Neoplasms. Tumors. Oncology. Including cancer and carcinogens Retrospective cohort study medicine.disease Radiation therapy Carcinoma Merkel Cell Survival Rate Treatment Outcome 030220 oncology & carcinogenesis Exclusive radiation Female Radiotherapy Adjuvant business Adjuvant |
Zdroj: | Radiation Oncology (London, England) Radiation Oncology, Vol 16, Iss 1, Pp 1-9 (2021) |
ISSN: | 1748-717X |
Popis: | Purpose Early stage Merkel cell carcinoma (MCC) is a rare and aggressive primary skin cancer. The standard of care for MCC is broad excision and adjuvant external beam radiation therapy (EBRT). However, for some patients, anesthesia is contraindicated, while others run the risk of serious aesthetic sequelae. In such cases, exclusive radiotherapy is an interesting alternative to surgery. Though limited data is available, this study evaluates exclusive radiotherapy for MCC, using data from the largest retrospective study to date. Methods All patients who were followed in our center between 1989 and 2019 for histologically proven early stage MCC were included in the study. They were treated either by surgery with a 2-cm clear margin followed by adjuvant radiotherapy (RT) or by exclusive RT. Survival rates with adjuvant and exclusive EBRT were analyzed using Cox model and Fine and Gray model depending on the type of survival. p value Results Eighty-four patients treated for MCC were included. Fifty-three of them (63.1%) were treated by exclusive RT, and 31 (36.9%) had surgical excision followed by adjuvant RT. Local relapse rate was 13.7% (95% CI 8.0–43.7) in the RT monotherapy group (group A) and 25.8% (95% CI 10.3–56.2) in the surgery + RT group (group B) (p = 0.42). No statistical difference was found for nodal relapse (p = 0.81), metastatic relapse (p = 0.10), disease free survival (p = 0.83) or overall survival (p = 0.98). Conclusion Our study suggests that exclusive radiotherapy for early Merkel cell carcinoma leads to a similar oncological outcome as combined treatment, with fewer aesthetic sequelae. The approach is interesting for elderly patients with comorbidities or patients for whom surgery would cause significant functional or aesthetic sequelae. |
Databáze: | OpenAIRE |
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