Chemotherapy compliance in high-risk Merkel cell carcinoma treated with chemoradiotherapy

Gorayski, Peter, Tripcony, Lee and Poulsen, Michael (2017) Chemotherapy compliance in high-risk Merkel cell carcinoma treated with chemoradiotherapy. Australasian Journal of Dermatology, 58 1: 35-41. doi:10.1111/ajd.12419


Author Gorayski, Peter
Tripcony, Lee
Poulsen, Michael
Title Chemotherapy compliance in high-risk Merkel cell carcinoma treated with chemoradiotherapy
Journal name Australasian Journal of Dermatology   Check publisher's open access policy
ISSN 1440-0960
0004-8380
Publication date 2017-02-01
Year available 2017
Sub-type Article (original research)
DOI 10.1111/ajd.12419
Open Access Status Not yet assessed
Volume 58
Issue 1
Start page 35
End page 41
Total pages 7
Place of publication Richmond, VIC Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2708 Dermatology
Abstract Objective: To evaluate chemotherapy (CT) compliance in patients treated with chemoradiotherapy (CRT) for high-risk Merkel cell cancer (MCC). Methods: Data from three prospective clinical trials in high-risk MCC performed by the Trans-Tasman Radiation Oncology Group were included in this analysis. Patients were treated with one of two carboplatin-based CT schedules and standardised radiotherapy (RT) to the primary site and nodes to a dose of 50–60 Gy in 25–30 fractions. Patients’ baseline characteristics were analysed using χ tests to determine compliance factors for completing CT. A Cox univariate analysis was performed to assess the impact of CT compliance on time to locoregional failure, time-to-distant failure, time-to-recurrence and time-to-death. Results: A total of 88 patients were identified, with a median follow up of 38.5 months. Of these, 75 (85%) completed CT (median age 64.2 years, range 62.0–66.4), while 13 did not (median age 72 years, range 68.1–75.9), P = 0.006. Women comprised 18/75 patients who completed CT and 7/13 patients who did not complete it (P = 0.03). Performance status, site, stage, surgical margins, RT dose and toxicity did not impact on their CT compliance. At 5 years, 26% of patients had locoregional relapse, 26% had distant failure and 34% had died. Conclusions: In this small cohort of patients treated with CRT for high-risk MCC, older age and female sex were associated with failure to complete CT. Severe acute skin and haematological toxicity did not correlate with failure to complete CT.
Formatted abstract
Objective

To evaluate chemotherapy (CT) compliance in patients treated with chemoradiotherapy (CRT) for high-risk Merkel cell cancer (MCC).

Methods

Data from three prospective clinical trials in high-risk MCC performed by the Trans-Tasman Radiation Oncology Group were included in this analysis. Patients were treated with one of two carboplatin-based CT schedules and standardised radiotherapy (RT) to the primary site and nodes to a dose of 50–60 Gy in 25–30 fractions. Patients’ baseline characteristics were analysed using χ2 tests to determine compliance factors for completing CT. A Cox univariate analysis was performed to assess the impact of CT compliance on time to locoregional failure, time-to-distant failure, time-to-recurrence and time-to-death.

Results

A total of 88 patients were identified, with a median follow up of 38.5 months. Of these, 75 (85%) completed CT (median age 64.2 years, range 62.0–66.4), while 13 did not (median age 72 years, range 68.1–75.9), P = 0.006. Women comprised 18/75 patients who completed CT and 7/13 patients who did not complete it (P = 0.03). Performance status, site, stage, surgical margins, RT dose and toxicity did not impact on their CT compliance. At 5 years, 26% of patients had locoregional relapse, 26% had distant failure and 34% had died.

Conclusions

In this small cohort of patients treated with CRT for high-risk MCC, older age and female sex were associated with failure to complete CT. Severe acute skin and haematological toxicity did not correlate with failure to complete CT.
Keyword Chemoradiotherapy
Compliance
Merkel cell carcinoma
Skin
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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