A Review of Radiotherapy for Merkel Cell Carcinoma of the Head and Neck.pdfVIP

Hindawi Publishing Corporation Journal of Skin Cancer Volume 2012, Article ID 563829, 6 pages doi:10.1155/2012/563829 Review Article A Review of Radiotherapy for Merkel Cell Carcinoma of the Head and Neck Justin Lee, Ian Poon, Judith Balogh, May Tsao, and Elizabeth Barnes Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada Correspondence should be addressed to Justin Lee, justin.lee@sunnybrook.ca Received 24 May 2012; Accepted 18 September 2012 Academic Editor: Brett A. Miles Copyright © 2012 Justin Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Merkel cell carcinoma of the head and neck (MCCHN) presents a clinical challenge due to its aggressive natural history, unpredictable lymphatic drainage, and high degree of treatment related morbidity. Histological examination of the regional lymph nodes is very important in determining the optimal treatment and is usually achieved by sentinel lymph node biopsy. Radiotherapy plays a critical role in the treatment of most patients with MCCHN. Surgery with adjuvant radiotherapy to the primary tumour site is associated with high local control rates. If lymph nodes are clinically or microscopically positive, adjuvant radiotherapy is indicated to decrease the risk of regional recurrence. The majority of locoregional recurrences occur at the edge or just outside of the radiation field, reflecting both the inherent radiosensitivity of MCC and the importance of relatively large volumes to include “in-transit” dermal lymphatic pathways. When surgical excision of the p