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Purpose: Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer. Treatment often includes high-dose radiation therapy (RT); however, studies suggest that even 8 Gy in 1 fraction can provide local control. Methods and Materials: In this retrospective, IRB-approved study, we mined the national Veterans Affairs Corporate Data Warehouse for MCC patients treated with RT. Using a combination of manual chart review and semiautomated data extraction from free-text notes, we collected information on diagnosis, tumor site and size, treatment technique, and radiation dose/fractionation. We assessed local and distant tumor control and overall survival as a function of radiation dose. Results: = .67, respectively). Distant progression-free probability was also independent of radiation dose. Conclusions: MCC is generally sensitive to RT, with traditionally palliative doses demonstrating similar local and distant disease control compared with higher dose regimens. Acknowledging several caveats to this work, these data support considering dose de-escalation as a treatment option for MCC.
Karki et al. (Tue,) studied this question.
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