How would you approach adjuvant radiation therapy for a Merkel cell carcinoma of the cheek in an immunocompromised patient?
For example, in a patient status-post WLE with a close (2.5 mm) deep margin and negative neck node sampling, would clinical (but not pathologic) PNI change your treatment? Would the decision on neck RT be swayed by the immunocompromised status? Any other modifications to your plan due to immunosuppression?
Answer from: Radiation Oncologist at Academic Institution
Merkel cell carcinoma, as previously discussed, is an extremely insidious and deadly malignancy, usually extending beyond what appear to be negative clinical borders. The fact that this patient is immune compromised has probably led to the development of skin malignancies, but otherwise will not pla...
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