Chemotherapy in neuroendocrine/Merkel cell carcinoma of the skin: case series and review of 204 cases.

Abstract

PURPOSE:

To study the use of chemotherapy for Merkel cell carcinoma (MCC) of the skin.

PATIENTS AND METHODS:

Twenty-five cases of MCC were treated at the London Regional Cancer Center between 1987 and 1997. Thirteen cases treated with chemotherapy were reviewed with 191 cases from the literature.

RESULTS:

At presentation, 24 patients had localized skin lesions (stage I) and one had locoregional involvement (stage II). Among the nine cases with recurrent nodal disease, six had chemotherapy as a component of salvage treatment. They were all free of disease at a median of 19 months (range, 12 to 37 months). In contrast, two patients who had salvage radiotherapy alone died of disease. Overall survival (OS) and disease-free survival (DFS) were 59% and 43%, respectively, at two years. Median OS and DFS were 29 months (range, 1 to 133 months) and 9 months (range, 1 to 133 months), respectively. Nodal disease developed in 12 (50%) of 24 patients with stage I disease, and distant metastases developed in six (25%) of 24. Including those from the literature, there were 204 cases treated with chemotherapy. Cyclophosphamide/doxorubicin (or epirubicin)/vincristine combination +/- prednisone was the most commonly used chemotherapy regimen (47 cases), with an overall response rate of 75.7% (35.1% complete, 35. 1% partial, and 5.4% minor responses). Etoposide/cisplatin (or carboplatin) was the next most commonly used regimen (27 cases), with an overall response rate of 60% (36% complete and 24% partial responses). The difference in response rate was not statistically significant (P =.19). Among the 204 cases, there were seven (3.4%) toxic deaths.

CONCLUSION:

Chemoradiation for locally recurrent or advanced disease may be an option for patients with a good performance status.

• Authors: P T Tai, E Yu, E Winquist, A Hammond, L Stitt, J Tonita, J Gilchrist
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 18 Issue 12 Pg. 2493-9 (Jun 2000) ISSN: 0732-183X [Print] United States
• PMID: 10856110 (Publication Type: Journal Article, Review)

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Merkel Cell (drug therapy, pathology, radiotherapy)
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Humans
• Karnofsky Performance Status
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Skin Neoplasms (drug therapy, pathology, radiotherapy)
• Treatment Outcome