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Impact of total radiotherapy dose on survival for head and neck Merkel cell carcinoma after resection
Author(s) -
Patel Sagar A.,
Qureshi Muhammad M.,
Mak Kimberley S.,
Sahni Debjani,
Giacalone Nicholas J.,
Ezzat Waleed,
Jalisi Scharukh,
Truong Minh Tam
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24776
Subject(s) - medicine , merkel cell carcinoma , radiation therapy , confidence interval , hazard ratio , head and neck cancer , stage (stratigraphy) , nuclear medicine , proportional hazards model , head and neck , adjuvant radiotherapy , carcinoma , surgery , urology , paleontology , biology
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.