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Elective radiation therapy for high-risk malignant melanomas.
J S Cooper1, W S Chang, R Oratz
1Department of Radiation Oncology, New York University School of Medicine, New York, USA.
Cancer Journal (Sudbury, Mass.)
|January 5, 2002
Summary
Elective radiation therapy after surgery significantly improved local-regional control rates for high-risk melanoma patients. While effective for residual disease, improved systemic therapies are needed to enhance overall survival.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- High-risk malignant melanomas often present with local-regional recurrence rates of 30%-50% post-surgery.
- Risk factors include multiple lymph node involvement, extracapsular spread, deep invasion, recurrent disease, and involved margins.
Purpose of the Study:
- To evaluate the efficacy of elective radiation therapy in managing high-risk malignant melanoma after surgical resection.
- To report initial outcomes of adjuvant radiation in a selected patient cohort.
Main Methods:
- A cohort of 40 patients with high-risk melanoma received elective radiation therapy post-surgery between 1993 and 1999.
- Radiation doses varied: 3000 cGy in five fractions (twice weekly) or 3600 cGy in six fractions.
Main Results:
- The actuarial 5-year local-regional control rate was 84% at a median follow-up of 18.4 months.
- Systemic recurrence rates were comparable to historical data for this patient subset.
- The actuarial overall survival rate at 5 years was 39%.
Conclusions:
- Elective radiation therapy effectively controls subclinical disease post-melanoma surgery.
- Adjuvant systemic therapies require development to reduce distant metastases and improve survival outcomes.