{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:52:53Z","timestamp":1788965573073,"version":"build-2803163510"},"reference-count":28,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"US Department of Veterans Affairs","doi-asserted-by":"publisher","award":["1IK2CX002049-01"],"award-info":[{"award-number":["1IK2CX002049-01"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["advancesradonc.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Advances in Radiation Oncology"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.adro.2026.102029","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T15:03:55Z","timestamp":1773759835000},"page":"102029","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["No Association Between Radiation Dose and Clinical Outcomes in Merkel Cell Carcinoma in the Veteran Population"],"prefix":"10.1016","volume":"11","author":[{"given":"Sudarshan","family":"Karki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cymon N.","family":"Kersch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"Melson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reid F.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.adro.2026.102029_bib0001","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.hoc.2024.05.013","article-title":"Merkel cell carcinoma","volume":"38","author":"Strong","year":"2024","journal-title":"Hematol Oncol Clin North Am"},{"key":"10.1016\/j.adro.2026.102029_bib0002","article-title":"Merkel cell carcinoma: An updated review of pathogenesis, diagnosis, and treatment options","volume":"35","author":"Hernandez","year":"2022","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.adro.2026.102029_bib0003","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.jaad.2017.10.028","article-title":"Merkel cell carcinoma: Current US incidence and projected increases based on changing demographics","volume":"78","author":"Paulson","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.adro.2026.102029_bib0004","doi-asserted-by":"crossref","DOI":"10.1038\/nrdp.2017.77","article-title":"Merkel cell carcinoma","volume":"3","author":"Becker","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"10.1016\/j.adro.2026.102029_bib0005","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1038\/s41419-025-07892-7","article-title":"The complex conundrum of Merkel cell carcinoma cellular ancestry","volume":"16","author":"Mazziotta","year":"2025","journal-title":"Cell Death Dis"},{"key":"10.1016\/j.adro.2026.102029_bib0006","doi-asserted-by":"crossref","first-page":"5228","DOI":"10.1158\/0008-5472.CAN-15-1877","article-title":"UV-associated mutations underlie the etiology of MCV-negative Merkel cell carcinomas","volume":"75","author":"Wong","year":"2015","journal-title":"Cancer Res"},{"key":"10.1016\/j.adro.2026.102029_bib0007","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1126\/science.1152586","article-title":"Clonal integration of a polyomavirus in human Merkel cell carcinoma","volume":"319","author":"Feng","year":"2008","journal-title":"Science"},{"key":"10.1016\/j.adro.2026.102029_bib0008","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.868781","article-title":"Prevalence of Merkel cell polyomavirus in normal and lesional skin: A systematic review and meta-analysis","volume":"12","author":"Wijaya","year":"2022","journal-title":"Front Oncol"},{"key":"10.1016\/j.adro.2026.102029_bib0009","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1016\/j.clon.2012.04.007","article-title":"Definitive radiotherapy or chemoradiotherapy in the treatment of Merkel cell carcinoma","volume":"24","author":"Sundaresan","year":"2012","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"10.1016\/j.adro.2026.102029_bib0010","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/j.ijrobp.2009.08.011","article-title":"The role of radiotherapy alone in patients with Merkel cell carcinoma: Reporting the Australian experience of 43 patients","volume":"78","author":"Veness","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102029_bib0011","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.radonc.2022.05.012","article-title":"Characterization of clinical outcomes after shorter course hypofractionated and standard-course radiotherapy for stage I-III curatively-treated Merkel cell carcinoma","volume":"173","author":"Liu","year":"2022","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.adro.2026.102029_bib0012","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.det.2007.08.005","article-title":"Radiation therapy toxicity to the skin","volume":"26","author":"FitzGerald","year":"2008","journal-title":"Dermatol Clin"},{"key":"10.1016\/j.adro.2026.102029_bib0013","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.2217\/fon-2020-1036","article-title":"How we treat Merkel cell carcinoma: Within and beyond current guidelines","volume":"17","author":"Park","year":"2021","journal-title":"Future Oncol"},{"key":"10.1016\/j.adro.2026.102029_bib0014","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/S0360-3016(01)01577-2","article-title":"Analysis of toxicity of Merkel cell carcinoma of the skin treated with synchronous carboplatin\/etoposide and radiation: A Trans-Tasman Radiation Oncology Group study","volume":"51","author":"Poulsen","year":"2001","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102029_bib0015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.6004\/jnccn.2024.0002","article-title":"NCCN Guidelines\u00ae insights: Merkel Cell Carcinoma, Version 1.2024: Featured Updates to the NCCN Guidelines","volume":"22","author":"Schmults","year":"2024","journal-title":"J Natl Compr Canc Netw"},{"key":"10.1016\/j.adro.2026.102029_bib0016","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/0360-3016(94)00610-W","article-title":"Radiation sensitivity of merkel cell carcinoma cell lines","volume":"32","author":"Leonard","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102029_bib0017","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.adro.2020.07.003","article-title":"Postoperative, single-fraction radiation therapy in Merkel cell carcinoma of the head and neck","volume":"5","author":"Cook","year":"2020","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.adro.2026.102029_bib0018","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1002\/cam4.458","article-title":"Single-fraction radiation therapy in patients with metastatic Merkel cell carcinoma","volume":"4","author":"Iyer","year":"2015","journal-title":"Cancer Med"},{"key":"10.1016\/j.adro.2026.102029_bib0019","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1259\/bjr\/31372149","article-title":"21 years of biologically effective dose","volume":"83","author":"Fowler","year":"2010","journal-title":"Br J Radiol"},{"key":"10.1016\/j.adro.2026.102029_bib0020","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"10.1016\/j.adro.2026.102029_bib0021","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/bjh.17476","article-title":"Thromboembolic risk in patients with lung cancer receiving systemic therapy","volume":"194","author":"Madison","year":"2021","journal-title":"Br J Haematol"},{"key":"10.1016\/j.adro.2026.102029_bib0022","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/01621459.1958.10501452","article-title":"Nonparametric estimation from incomplete observations","volume":"53","author":"Kaplan","year":"1958","journal-title":"J Am Stat Assoc"},{"key":"10.1016\/j.adro.2026.102029_bib0023","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.21105\/joss.01317","article-title":"Lifelines: Survival analysis in Python","volume":"4","author":"Davidson-Pilon","year":"2019","journal-title":"J Open Source Softw"},{"key":"10.1016\/j.adro.2026.102029_bib0024","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.310.6973.170","article-title":"Statistics notes: Multiple significance tests: The Bonferroni method","volume":"310","author":"Bland","year":"1995","journal-title":"BMJ"},{"key":"10.1016\/j.adro.2026.102029_bib0025","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1002\/hed.24776","article-title":"Impact of total radiotherapy dose on survival for head and neck Merkel cell carcinoma after resection","volume":"39","author":"Patel","year":"2017","journal-title":"Head Neck"},{"key":"10.1016\/j.adro.2026.102029_bib0026","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1001\/jamadermatol.2017.2176","article-title":"Identifying an optimal adjuvant radiotherapy dose for extremity and trunk Merkel cell carcinoma following resection: An analysis of the National Cancer Database","volume":"153","author":"Patel","year":"2017","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.adro.2026.102029_bib0027","first-page":"175","article-title":"Optimal adjuvant radiotherapy dose for stage I, II or III Merkel cell carcinoma: An analysis of the National Cancer Database","volume":"50","author":"Yusuf","year":"2020","journal-title":"Jpn J Clin Oncol"},{"key":"10.1016\/j.adro.2026.102029_bib0028","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.ijrobp.2009.05.067","article-title":"Effect of radiotherapy dose and volume on relapse in Merkel cell cancer of the skin","volume":"77","author":"Foote","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Advances in Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2452109426000369?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2452109426000369?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:47:37Z","timestamp":1781261257000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2452109426000369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S2452109426000369"],"URL":"https:\/\/doi.org\/10.1016\/j.adro.2026.102029","relation":{},"ISSN":["2452-1094"],"issn-type":[{"value":"2452-1094","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"No Association Between Radiation Dose and Clinical Outcomes in Merkel Cell Carcinoma in the Veteran Population","name":"articletitle","label":"Article Title"},{"value":"Advances in Radiation Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.adro.2026.102029","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.","name":"copyright","label":"Copyright"}],"article-number":"102029"}}