title: The treatment of advanced Merkel cell carcinoma. A multimodality chemotherapy and radiation therapy treatment approach.
abstract: BACKGROUND
  The optimal management of Merkel cell carcinoma has not been clearly defined.
  
  
  OBJECTIVE
  To describe the treatment of eight patients who presented with Merkel cell carcinoma.
  
  
  METHODS
  Eight patients with advanced locoregional Merkel cell carcinoma were seen in our institute over a 7-year period. Four patients were successfully treated by induction chemotherapy after excisional biopsy, followed by radiotherapy. Three patients died from widespread metastases and one from neutropenic sepsis induced by chemotherapy.
  
  
  RESULTS
  These cases demonstrate the potential lethality and aggressive nature of this rare skin tumor despite its chemosensitive and radioresponsive character. In all four patients who are alive and disease-free, chemotherapy was given first and radiotherapy was given as consolidation.
  
  
  CONCLUSIONS
  We suggest that a multimodality treatment approach--chemotherapy followed by radiotherapy--is indicated in patients with advanced Merkel cell carcinoma.
authors.affiliation: Institute of Oncology, Beilinson Medical Center, Petah Tiqva, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Fenig
authors.forename: H
authors.initials: H
authors.lastname: Lurie
authors.forename: B
authors.initials: B
authors.lastname: Klein
authors.forename: A
authors.initials: A
authors.lastname: Sulkes
mesh_terms: D000328:Adult; D000368:Aged; D015266:Carcinoma, Merkel Cell / Q000188:drug therapy* / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery