What is the role of radiation therapy in the treatment of Merkel cell carcinoma (MCC)?

Updated: Jan 18, 2019
  • Author: Arjun S Joshi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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As the sole treatment for localized (stage I) lesions, radiation therapy has been used with some success. In the Bishop study, no regional recurrences were found among 22 patients with gross nodal disease who received radiation therapy but no neck dissection. [30] However, some studies have demonstrated high rates of local-regional recurrence in patients treated with radiation alone. [32]

Radiation therapy is not recommended as treatment for primary disease in patients able to undergo surgery. It is used as a primary treatment when patients are unable to tolerate surgery or when wide resection is required to remove the disease with a negative margin.

Radiation therapy is most often used an adjunctive therapy after surgical resection of the primary lesion and/or affected nodal basins. In one study, postoperative radiation therapy appeared to reduce local recurrence rates from 44% to 12%. A meta-analysis of 333 reports in the literature concluded that surgery plus radiation therapy decreases the rates of local and regional recurrence as compared to surgery alone. [33]

Radiation therapy may also be used in the palliative setting to reduce symptoms of pain, bleeding, ulceration, and secondary infection.

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