Disease presentation and outcome in young patients (<40 years) with brain metastases from malignant melanoma

While elderly patients with brain metastases from malignant melanoma apparently have an unfavourable prognosis, little information is available on disease presentation and treatment outcome in youngest patients. Considering this, our experience with radiation therapy in this particular subset was evaluated. Our database with 48 melanoma patients contained three patients aged <40 years. All received whole-brain radiation therapy plus steroids and individual systemic measures according to the institutional policy. In one case, brain metastases were present already at first diagnosis of melanoma. The maximum interval to diagnosis of brain metastases was 21 months. All the patients were male and had multiple lesions (at least 6) plus extracranial metastases. None of them died from extracranial disease. The maximum survival was 5 months. Thus, our young patients with brain metastases did not achieve a better outcome than intermediate age groups. Whole-brain radiation therapy was not able to provide durable CNS control. Prospective studies on treatment intensification appear warranted.