{"doi":"10.1016/j.adro.2020.07.003","title":"Postoperative, Single-Fraction Radiation Therapy in Merkel Cell Carcinoma of the Head and Neck","abstract":"PURPOSE: Conventionally fractionated, postoperative radiation therapy (cPORT; 50 Gy in 25 fractions) is considered for patients with Merkel cell carcinoma (MCC) to improve locoregional control. However, cPORT is associated with acute toxicity, especially in the head and neck (H&N) region, and requires daily treatments over several weeks. We previously reported high rates of durable local control with minimal toxicity using 8-Gy single-fraction radiation therapy (SFRT) in the metastatic setting. We report early results on a cohort of patients with localized H&N MCC who received postoperative SFRT if a cPORT regimen was not feasible. METHODS AND MATERIALS: Twelve patients with localized MCC of the H&N (clinical/pathologic stages I-II) and no prior radiation therapy to the region were identified from an institutional review board-approved prospective registry who underwent surgical resection followed by postoperative SFRT. Time to event was calculated starting from the date of resection before SFRT. The cumulative incidence of in-field locoregional recurrences and out-of-field recurrences was estimated with death as a competing risk. RESULTS: Twelve patients with H&N MCC were identified with clinical/pathologic stages I-II H&N MCC. Median age at diagnosis was 81 years (range, 58-96 years); 25% had immunosuppression. At a median follow-up of 19 months (range, 8-34), there were no in-field locoregional recurrences. A single out-of-field regional recurrence was observed, which was successfully salvaged. There were no MCC-specific deaths. No radiation-associated toxicities greater than grade 1 (Common Terminology Criteria for Adverse Events v5) were observed. CONCLUSIONS: Preliminary data suggest that SFRT could offer a potential alternative to cPORT to treat the primary site for localized H&N MCC, particularly in elderly or frail patients, with promising in-field local control and minimal toxicity. Further data with validation in larger cohorts are needed to confirm the sustained safety and efficacy of postoperative SFRT.","journal":"Advances in Radiation Oncology","year":2020,"id":100861,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":28,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9554,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":494358,"name":"Stephanie K. Schaub","orcid":"0000-0002-5148-379X","position":1,"is_corresponding":false},{"id":494359,"name":"Peter H. Goff","orcid":"0000-0002-3488-4997","position":2,"is_corresponding":false},{"id":494360,"name":"Alex Z. Fu","orcid":"0000-0002-4020-6519","position":3,"is_corresponding":false},{"id":285792,"name":"Song Y. Park","orcid":"0000-0003-4366-1821","position":4,"is_corresponding":false},{"id":420625,"name":"Daniel S. Hippe","orcid":"0000-0003-2427-4404","position":5,"is_corresponding":false},{"id":494361,"name":"Jay J. Liao","orcid":"0000-0003-4679-3037","position":6,"is_corresponding":false},{"id":494362,"name":"Smith Apisarnthanarax","orcid":"0000-0003-4522-8300","position":7,"is_corresponding":false},{"id":230463,"name":"Shailender Bhatia","orcid":"0000-0002-3816-2238","position":8,"is_corresponding":false},{"id":494363,"name":"Yolanda D. Tseng","orcid":"0000-0002-4070-346X","position":9,"is_corresponding":false},{"id":287858,"name":"Paul Nghiem","orcid":"0000-0003-2784-963X","position":10,"is_corresponding":false},{"id":494364,"name":"Upendra Parvathaneni","orcid":"0000-0003-2370-4492","position":11,"is_corresponding":false},{"id":472359,"name":"Maclean M. Cook","orcid":null,"position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":null,"created_at":"2026-07-18T22:39:01.863288Z","pmid":"32838069","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}