Postoperative Radiotherapy for Cutaneous Melanoma in Patients at High Risk of Local-Regional Recurrence after Surgery...

Area of Science:

• Oncology
• Dermatology
• Radiation Oncology

Background:

• Cutaneous melanoma poses a significant recurrence risk after surgery, especially in high-risk patients.
• Adjuvant therapies are crucial for improving outcomes in patients with advanced or high-risk melanoma.
• Postoperative radiotherapy is a potential treatment modality to reduce recurrence and improve survival.

Purpose of the Study:

• To evaluate the long-term outcomes of surgery and postoperative radiotherapy in patients with high-risk cutaneous melanoma.
• To assess the efficacy of radiotherapy in preventing local-regional recurrence and distant metastasis.
• To determine the overall survival and cause-specific survival rates following this treatment regimen.

Main Methods:

• A retrospective analysis of 131 high-risk cutaneous melanoma patients treated with surgery and postoperative radiotherapy.
• Patients received either hypofractionated (102 patients) or conventional fractionation (29 patients) radiotherapy.
• Follow-up duration was a median of 3.6 years, with 10-year outcomes analyzed.

Main Results:

• 10-year in-field local-regional control was 87%, and overall local regional control was 72%.
• Distant metastasis-free survival was 48%, cause-specific survival was 44%, and overall survival was 31%.
• Adverse events were low, with 3 patients experiencing acute toxicities and 6 experiencing late toxicities.

Conclusions:

• Surgery combined with postoperative radiotherapy demonstrates significant efficacy in achieving local-regional control for high-risk cutaneous melanoma.
• While local control is high, distant metastasis and overall survival rates indicate a need for further research and potentially systemic therapies.
• Radiotherapy is a well-tolerated adjuvant treatment option for this patient population, with a manageable toxicity profile.