Improved local and regional control with radiotherapy for Merkel cell carcinoma of the head and neck

Head Neck. 2017 Jan;39(1):48-55. doi: 10.1002/hed.24527. Epub 2016 Jun 14.

Abstract

Background: We hypothesized that radiotherapy (RT) would improve both local and regional control with Merkel cell carcinoma of the head and neck.

Methods: A single-institution institutional review board-approved study was performed including 113 patients with nonmetastatic Merkel cell carcinoma of the head and neck. Postoperative RT was delivered to the primary tumor bed (71.7% cases) ± draining lymphatics (33.3% RT cases).

Results: Postoperative local RT was associated with improved local control (3-year actuarial local control 89.4% vs 68.1%; p = .005; Cox hazard ratio [HR] 0.18; 95% confidence interval [CI] = 0.06-0.55; p = .002). Similarly, regional RT was associated with improved regional control (3-year actuarial regional control 95.0% vs 66.7%; p = .008; Cox HR = 0.09; 95% CI = 0.01-0.69; p = .02). Regional RT played an important role for both clinical node-negative patients (3-year regional control 100% vs 44.7%; p = .03) and clinical/pathological node-positive patients (3-year regional control 90.9% vs 55.6%; p = .047).

Conclusion: Local RT was beneficial for all patients with Merkel cell carcinoma of the head and neck, whereas regional RT was beneficial for clinical node-negative and clinical/pathological node-positive patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 48-55, 2017.

Keywords: Merkel cell carcinoma; local control; radiotherapy; regional control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Merkel Cell / pathology
  • Carcinoma, Merkel Cell / radiotherapy*
  • Carcinoma, Merkel Cell / surgery*
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Skin Neoplasms / pathology
  • Skin Neoplasms / radiotherapy*
  • Skin Neoplasms / surgery*
  • Treatment Outcome