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Head Neck. 2017 Jul;39(7):1371-1377. doi: 10.1002/hed.24776. Epub 2017 Mar 29.

Impact of total radiotherapy dose on survival for head and neck Merkel cell carcinoma after resection.

Author information

1
Harvard Radiation Oncology Program, Boston, Massachusetts.
2
Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
3
Department of Dermatology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
4
Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.

Abstract

BACKGROUND:

Head and neck Merkel cell carcinoma (MCC) is commonly treated with surgery and adjuvant radiotherapy (RT) for high-risk features. The optimal radiation dose is unknown.

METHODS:

One thousand six hundred twenty-five eligible patients with head and neck MCC were identified in the National Cancer Data Base (NCDB). Radiation dose was divided into 3 groups: 30 to <50 Gray (Gy), 50-55 Gy, and >55-70 Gy. Cox regression was used to compare overall survival (OS) between groups, accounting for age, sex, stage, surgery type, margin status, comorbidities, and use of chemotherapy.

RESULTS:

With a median follow-up of 33.5 months, 3-year OS was 48.9%, 70.3%, and 58.7% for 30 to <50 Gy, 50-55 Gy, and >55-70 Gy, respectively (P < .001). Compared to 50-55 Gy, doses between 30 to <50 Gy (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI] 1.17-1.99; P = .002) and >55-70 Gy (adjusted HR 1.21; 95% CI 1.0-1.46; P = .06) were associated with worse survival.

CONCLUSION:

Adjuvant radiation doses within 50-55 Gy may be optimal for head and neck MCC.

KEYWORDS:

Merkel cell carcinoma; adjuvant therapy; head and neck; radiation dose; radiotherapy

PMID:
28370725
DOI:
10.1002/hed.24776
[Indexed for MEDLINE]

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