Journal of the American Academy of Dermatology · 2026
One dose of adjuvant 8 Gray postoperative radiotherapy for Merkel cell carcinoma excised with narrow margins: Low toxicity and comparable efficacy to conventional radiotherapy.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Huynh Emily T, Ch'en Peter Y, Hippe Daniel S, Fan Xinyi, Goff Peter H, Biese Kate, Fu Alex, Menon Ankita, Harikrishnan Nikhil, Lachance Kristina, Wallner Kent, Panjwani Neil, Parvathaneni Upendra, Tseng Yolanda D, Akaike Tomoko, Zaba Lisa C, Nghiem Paul
Аннотация
BACKGROUND: Merkel cell carcinoma (MCC) recurs in 17% to 30% of patients with stage I to II disease, with local recurrence rates between 2% and 27%. Per established guidelines, conventional postoperative radiotherapy (cPORT; ∼50 Gray across 25 fractions) should be considered for localized MCC when risk factors are present. cPORT can be morbid and logistically challenging. Single-fraction radiotherapy (SFRT) of 8 Gray has utility and low toxicity for palliation but remains underexplored postoperatively.
OBJECTIVE: Evaluate postoperative SFRT for stage I to II MCC, compared to observation and cPORT.
METHODS: Local recurrences were assessed for observation (n = 108 patients), cPORT (n = 156), or SFRT (n = 43) groups.
RESULTS: Observation patients had fewer per-patient risk factors (mean: 1.2 vs 1.6 for SFRT [P = .020] and 1.6 for cPORT [P = .001]). Despite this, 3-year local control was better for cPORT (97.4%; P < .001) and SFRT (100%; P = .012) groups than observation (91.0%), particularly in patients with narrow surgical margins (≤1 cm). Adverse events occurred in 21% of SFRT patients (all grade 1).
LIMITATIONS: Single-center retrospective study.
CONCLUSIONS: The SFRT group experienced improved local control relative to observation and had comparable local control to the cPORT group. For early-stage narrowly excised MCC, SFRT is feasible, well tolerated, and warrants exploration in a prospective multicenter study.
OBJECTIVE: Evaluate postoperative SFRT for stage I to II MCC, compared to observation and cPORT.
METHODS: Local recurrences were assessed for observation (n = 108 patients), cPORT (n = 156), or SFRT (n = 43) groups.
RESULTS: Observation patients had fewer per-patient risk factors (mean: 1.2 vs 1.6 for SFRT [P = .020] and 1.6 for cPORT [P = .001]). Despite this, 3-year local control was better for cPORT (97.4%; P < .001) and SFRT (100%; P = .012) groups than observation (91.0%), particularly in patients with narrow surgical margins (≤1 cm). Adverse events occurred in 21% of SFRT patients (all grade 1).
LIMITATIONS: Single-center retrospective study.
CONCLUSIONS: The SFRT group experienced improved local control relative to observation and had comparable local control to the cPORT group. For early-stage narrowly excised MCC, SFRT is feasible, well tolerated, and warrants exploration in a prospective multicenter study.