Meeuwissen J A, Bourne R G, Kearsley J H
Queensland Radium Institute, Royal Brisbane Hospital, Australia.
Int J Radiat Oncol Biol Phys. 1995 Jan 15;31(2):325-31. doi: 10.1016/0360-3016(94)E0145-A.
To determine the role of postoperative radiation therapy in the treatment of Merkel cell carcinoma (MCC).
Eighty patients with MCC of the skin were treated with curative intent at the Queensland Radium Institute between 1981 and 1991. Fifty-one patients (63.7%) were referred after initial biopsy for further treatment and 29 patients (36.3%) were referred with locally recurrent disease following primary surgery elsewhere. Thirteen patients (16.3%) presented with nodal disease without a clinically definable primary skin lesion.
Of the 80 patients, 38 had undergone surgery (S) alone, 34 surgery plus radiotherapy (S + RT), 7 RT after incomplete S, and 1 patient had chemotherapy (CT) plus RT. Overall survival at 36 months for all patients was 68%. All of the 38 patients treated with S alone relapsed. The median time to recurrence was 5.5 months. Ten of the 34 patients treated with S + RT relapsed. The median time to recurrence was 16.5 months. Of the 80 patients, 55 have relapsed after primary treatment, 25 have developed systemic metastases, and 26 patients have died as a direct result of MCC.
Our large series confirms earlier reports from this Institute and highlights the importance of S + RT over S alone in preventing local recurrence of this highly malignant skin cancer.
确定术后放射治疗在默克尔细胞癌（MCC）治疗中的作用。
1981年至1991年间，昆士兰镭研究所对80例皮肤MCC患者进行了根治性治疗。51例患者（63.7%）在初次活检后转诊接受进一步治疗，29例患者（36.3%）因其他地方原发手术后局部复发而转诊。13例患者（16.3%）出现淋巴结疾病，无临床可明确的原发性皮肤病变。
80例患者中，38例仅接受了手术（S），34例接受了手术加放疗（S + RT），7例在不完全手术（S）后接受了放疗，1例患者接受了化疗（CT）加放疗。所有患者36个月时的总生存率为68%。仅接受S治疗的38例患者均复发。复发的中位时间为5.5个月。接受S + RT治疗的34例患者中有10例复发。复发的中位时间为16.5个月。80例患者中，55例在初次治疗后复发，25例发生全身转移，26例患者直接死于MCC。
我们的大样本系列研究证实了本研究所早期的报告，并强调了S + RT相对于单独S在预防这种高恶性皮肤癌局部复发方面的重要性。
