Radiation therapy of malignant melanoma: experience with high individual treatment doses

Reports of the existence of a large shoulder on the radiation survival curve of cultured mouse and human malignant melanoma cells prompted a clinical trial of radiation therapy using high individual-dose-fractionation schedules. Typically, individual doses of larger than or equal to 600 rads were delivered once or twice weekly. The most clear-cut effect was against skin metastases. Twenty-nine of 33 lesions showed partial or complete regression when treated in this manner. None of 11 lesions responded that were treated with individual treatment doses of 200 to 500 rads, although in some cases the total doses were greater than 5000 rads. Some of the possible roles for an effective radiation regimen in the overall management of this complex disease are discussed.