Radiotherapy of primary human melanomas--experiences and suggestions

We treated 60 invasive primary human melanomas by soft X-rays. In 23 additional cases radiotherapy was applied after total excision of a primary melanoma. Only in two cases was a tumor observed in the field of irradiation during the follow-up period: a recurrence of a primary melanoma and a skin metastasis. Radioresistance cannot be unequivocally assumed in either case. Since deeply situated in-transit metastases cannot be destroyed by soft X-rays in spite of our good results we regard radiotherapy of invasive primary melanomas as a second choice treatment to be administered if impaired general health, excessive tumor growth in certain localisations or refusal of the patient do not allow a major operation. Nodular parts of primary melanomas should be excised before radiotherapy to obtain material for histopathological confirmation of the diagnosis and to determine the thickness of the tumor. X-rays of lower hardness can subsequently be applied.