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Exclusive Radiotherapy: Potential Alternative to Surgery for Merkel Cell Carcinoma?

By: Joshua D. Madera, MS
Posted: Friday, August 13, 2021

The use of radiotherapy exclusively to treat Merkel cell carcinoma may prove to be an effective alternative option to combined treatment, according to a study published in Radiation Oncology. “The approach is interesting for elderly patients with comorbidities or patients for whom surgery would cause significant functional or aesthetic sequelae,” explained Laurent Mortier, MD, PhD, of the Centre Hospitalier Universitaire de Lille, France, and colleagues.

From 1989 to 2019, a total of 84 patients with Merkel cell carcinoma were recruited for the study. Patients either received exclusive radiotherapy (n = 53) or surgical excision followed by radiotherapy (n = 31). Subsequently, patients were scheduled for follow-up once every 3 months over a 3-year period for clinical assessment and imaging.

The study findings revealed a local relapse rate of 13.7% and 25.8% for patients treated with exclusive radiotherapy and for those treated with surgery plus radiotherapy, respectively. However, no significant differences were identified between the groups for metastatic relapse (P = .10), nodal relapse (P = .81), overall survival (P = .98), or disease-free survival (P = .83). Furthermore, the median follow-up period for patients in the exclusive-radiotherapy group and surgery-plus-radiotherapy group was 64 months and 95 months, respectively. Moreover, a total of 57 patients experienced disease relapse or died; a total of 66.6% of these patients received exclusive radiotherapy, whereas 74.2% of these patients underwent surgery plus radiotherapy.

“We believe that it is imperative not to delay the radiotherapy, and for this reason, we have reduced margins and promoted surgery allowing a direct suture, in order to obtain a rapid wound healing and early irradiation,” commented Dr. Mortier.

Disclosure: For full disclosures of the study authors, visit biomedcentral.org.



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