ArticleInternational journal of radiation oncology, biology, physics2018
Effect of Patient Immune Status on the Efficacy of Radiation Therapy and Recurrence-Free Survival Among 805 Patients With Merkel Cell Carcinoma.
Article in International journal of radiation oncology, biology, physics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 31 citations in OpenAlex.
- A prospective observational study of inflammatory mediators in cerebrospinal fluid after intraoperative radiotherapy of brain tumors.Therapeutic advances in medical oncology · 2025Article
- Increased risk of recurrence and disease-specific death following delayed postoperative radiation for Merkel cell carcinoma.Journal of the American Academy of Dermatology · 2024Article
- Survival of Patients With Head and Neck Merkel Cell Cancer: Findings From the Pan-Canadian Merkel Cell Cancer Collaborative.JAMA network open · 2023Article
- Harnessing the Immunological Effects of Radiation to Improve Immunotherapies in Cancer.International journal of molecular sciences · 2023Review
- Circulating Lymphocyte Counts Early During Radiation Therapy Are Associated With Recurrence in Pediatric Medulloblastoma.International journal of radiation oncology, biology, physics · 2021Article
- Merkel Cell Carcinoma of the Head and Neck: Epidemiology, Pathogenesis, Current State of Treatment and Future Directions.Cancers · 2021Review
- Paraneoplastic neurological syndromes: clinical presentations and management.Therapeutic advances in neurological disorders · 2021Review
- Secondary Immunodeficiency in Hematological Malignancies: Focus on Multiple Myeloma and Chronic Lymphocytic Leukemia.Frontiers in immunology · 2021Review
- Immune status and the efficacy of adjuvant radiotherapy for patients with localized Merkel cell carcinoma of the head and neck.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020Article
- Merkel Cell Polyoma Viral Load and Intratumoral CD8+ Lymphocyte Infiltration Predict Overall Survival in Patients With Merkel Cell Carcinoma.Frontiers in oncology · 2019Article
- Does Neutron Radiation Therapy Potentiate an Immune Response to Merkel Cell Carcinoma?International journal of particle therapy · 2018Article
- Postoperative, Single-Fraction Radiation Therapy in Merkel Cell Carcinoma of the Head and Neck.Advances in radiation oncologyArticle
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
purposePatients with Merkel cell carcinoma (MCC) with chronic immunosuppression (IS) have worse outcomes, but the mechanisms are not well understood. We hypothesized that these differences may be mediated in part by differential response to treatment, and we evaluated whether radiation therapy (RT) efficacy is altered among IS compared with immune-competent (IC) patients with MCC. METHODS AND MATERIALS: Among 805 patients with MCC, recurrence-free survival (RFS) and patterns of first recurrence were compared between 89 IS and 716 IC patients with stage I to III MCC treated with curative intent. We used a Fine and Gray's competing risk multivariable analysis to estimate associations with RFS.
resultsIS and IC patients with MCC had similar demographic and disease characteristics. Most (77% IC, 86% IS) were irradiated (median, 50.4 Gy IC, 50.3 Gy IS), although more IS patients were irradiated to the primary site (97% vs 81%). With a median follow-up of 54.4 months, IS patients had inferior RFS (2-year: 30% vs 57%; P < .0001) and higher rates of local recurrence as the first site of relapse (25% vs 12%; P = .0002). The association between RT and RFS differed by immune status (interaction P = .01). Although RT was associated with significantly improved RFS among IC patients (hazard ratio 0.56, 95% confidence interval 0.44-0.72), no difference in RFS was observed with RT among IS patients (hazard ratio 1.49, 95% confidence interval 0.70-3.17).
conclusionsRadiation therapy efficacy at current standard RT doses for MCC is impaired among immunosuppressed patients with MCC. Although a strong link between durability of RT response and immune function does not appear to be evident in most cancers, our results may reflect an especially dynamic interaction between immune status and RT efficacy in MCC.
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