Merkel cell carcinoma: improved locoregional control with postoperative radiation therapy

Article Abstract:

Merkel cell carcinoma is a particularly aggressive form of skin cancer. It was called 'trabecular carcinoma' when first described, but later it was discovered that this form of cancer had features in common with Merkel cells, sensory cells found in some touch receptors in the skin and in some specialized locations including the mouth. The Merkel cell cancer is now known to secrete several hormones, including calcitonin, and some experts have suggested calling the cancer neuroendocrine carcinoma of the skin, but the name Merkel cell carcinoma remains widely used. The authors describe their experience with 11 cases of Merkel cell carcinoma treated with radiation therapy over a 10-year period. Three of the 11 patients had massive metastatic disease and were successfully treated with radiation for palliation only. The other eight patients received surgical treatment followed by radiation therapy. No residual tumor was apparent after surgery in any of the eight patients. In seven of the eight patients, this treatment achieved control of the cancer for follow-up periods of up to 64 months. A review of the literature indicates that Merkel cell carcinomas may occur anywhere from 23 to 96 years of age, but are most common in patients in their 50s and 60s. About 46 percent of Merkel cell carcinoma primary tumors occur on the head and neck, and about 44 percent on the arms and legs. Reports in the literature indicate that surgery alone is unsatisfactory, and many surgically treated patients will experience local recurrence. However, if the surgical treatment is supplemented with postoperative radiation, then local control is excellent and provides a good chance for long-term survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The role of radiotherapy in the treatment of malignant sweat gland neoplasms

Article Abstract:

Malignant tumors of the sweat glands are sufficiently rare that it is unlikely any institution will have experience in studying these tumors. The result is that many such cancers are treated on the basis of anecdotal information; review of 35 sweat gland cancers reported in the literature revealed that none had been correctly diagnosed prior to surgical excision. Sweat gland tumors become malignant rapidly and are usually fatal. Three cases were referred for postoperative irradiation. Although some have suggested that sweat gland cancers are generally unresponsive to radiotherapy, there is little data given to support this point. Since much of the rationale for local irradiation after surgery is to kill cancer cells in nerve sheaths and lymphatic ducts, the presence of these histologic features in the sweat gland tumors removed from the three patients suggested that radiotherapy might indeed be appropriate. All patients were given 70 Gy to the tumor bed and 50 Gy to regional lymphatic chains (a Gy, or Gary, is 1 joule of energy absorbed per kilogram of tissue). One patient died of rapid tumor spread. However, two patients remain disease-free 27 and 35 months after treatment. Sweat gland tumor cases may now be enrolled in a registry established at St. John's Mercy Hospital in St. Louis, which will facilitate the accumulation of knowledge about this rare cancer and aid in the formulation of educated opinions about diagnosis and treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Basal cell carcinoma treated with radiation therapy

Article Abstract:

Basal cell carcinoma is not only the most common form of skin cancer, but may be the most common form of cancer of any type. Fortunately, basal cell carcinoma progresses very slowly, and metastatic spread to distant parts of the body is exceptionally rare. This form of cancer is invasive, however, and may invade adjacent cartilage, bone, or muscle. Basal cell carcinoma gets its name from its origin among the basal cells of the epidermis of the skin; it may result from many causes, but most cases occur in areas of the skin that are exposed to sunlight. A variety of surgical techniques have been applied to the control of basal cell carcinoma, including methods such as the freezing of the cancer (cryotherapy). In general, the results are good, and reported success rates are as high as 99 percent. From 1974 to 1989, 85 of 115 patients with basal cell carcinomas were treated at one medical center with radiation therapy. Half of the patients were followed-up for at least 40 months. Although the local control rate of recurrent basal cell carcinoma is generally less favorable, the five-year local control rate of recurrent Stage I and Stage II basal cell carcinoma was 95 percent among these patients. These findings demonstrate that high cure rates can be achieved by treating Stage I and II basal cell carcinoma with radiation therapy and that this treatment is effective for treating recurrences of these cancers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Basal cell carcinoma

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