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Adjuvant irradiation for cervical lymph node metastases from melanoma
Matthew T Ballo1, Mark D Bonnen, Adam S Garden
1Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas77030, USA. mballo@mdanderson.org
Cancer
|March 26, 2003
Summary
Adjuvant radiotherapy after surgery for melanoma lymph node metastases achieved a 94% regional control rate at 10 years with rare complications. It is recommended for high-risk patients.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Regional disease recurrence is a known risk after surgery for melanoma lymph node metastases.
- The efficacy of adjuvant irradiation in this setting remains a subject of debate.
Purpose of the Study:
- To evaluate the effectiveness and safety of adjuvant radiotherapy in patients with melanoma lymph node metastases.
- To identify patient and tumor characteristics influencing outcomes.
Main Methods:
- Retrospective review of 160 patients with cervical lymph node metastases from melanoma.
- All patients received surgery and adjuvant radiotherapy (median 30 Gy).
- Surgical approaches included selective neck dissection, local excision, or radical neck dissection.
Main Results:
- 10-year actuarial regional control rate was 94% with adjuvant radiotherapy.
- Disease-specific survival and distant metastasis-free survival were significantly worse in patients with four or more involved lymph nodes.
- The 5-year complication-free survival rate was 90%, with rare and manageable treatment-related complications.
Conclusions:
- Adjuvant radiotherapy significantly improves regional control in melanoma lymph node metastases.
- Recommended for patients with extracapsular extension, large lymph nodes (≥3 cm), multiple involved nodes, or recurrent disease.
- Adjuvant irradiation is a safe and effective treatment option with a low complication rate.