Melanoma: Last call for radiotherapy.

Area of Science:

• Oncology
• Radiation Oncology
• Immunology

Background:

• Melanoma is historically considered radioresistant.
• Recent advancements in radiotherapy and immunotherapy challenge this notion.
• High-dose stereotactic radiotherapy and novel hadrontherapy offer potential benefits.

Purpose of the Study:

• To review the biological and clinical effects of advanced radiotherapy in melanoma.
• To explore the synergistic potential of radiotherapy and immunotherapy.
• To discuss the role of hadrontherapy in treating melanoma.

Main Methods:

• Review of current literature on radiotherapy and immunotherapy in melanoma.
• Analysis of biological mechanisms of high-dose radiotherapy (e.g., DNA damage, endothelial apoptosis).
• Evaluation of immune-modulating effects of radiotherapy and potential abscopal effects.

Main Results:

• High-dose stereotactic radiotherapy can induce lethal DNA damage and improve local control.
• Radiotherapy can enhance anti-tumor immune responses through neoantigen formation and cytokine release.
• Hadrontherapy may overcome hypoxia-induced radioresistance and improve outcomes in challenging locations.

Conclusions:

• Advanced radiotherapy techniques, including stereotactic radiotherapy and hadrontherapy, hold promise for melanoma treatment.
• The combination of radiotherapy and immunotherapy is expected to yield synergistic effects, potentially including abscopal responses.
• Further clinical trials are necessary to establish definitive indications for innovative radiotherapy in melanoma management.