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Radiation therapy for malignant melanoma

F B Geara¹, K K Ang

¹Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, USA.

The Surgical Clinics of North America

|December 1, 1996

Summary

Melanoma is not uniformly radiation resistant, challenging old dogmas. Radiation therapy offers a viable alternative for specific melanoma cases, improving local control and palliation.

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Area of Science:

Oncology
Radiation Oncology

Background:

Historically, melanomas were considered uniformly radiation resistant.
This dogma limited the role of radiation therapy in melanoma management.

Purpose of the Study:

To evaluate the current evidence for radiation therapy's role in melanoma management.
To identify specific melanoma subsets where radiation therapy is a viable alternative or adjunct.

Main Methods:

Review of retrospective and Phase II prospective studies.
Analysis of data on elective/adjunctive radiation therapy for primary and metastatic melanomas.
Consideration of palliative radiation therapy for symptomatic metastatic disease.

Main Results:

Radiation therapy is a viable alternative for localized melanomas causing cosmetic/functional deformity (e.g., lentigo maligna, uveal melanomas).
Elective/adjunctive radiation therapy improves local-regional control in specific patient groups (thick primary lesions, nodal involvement, mucosal melanomas).
Radiation therapy is effective for palliation of symptomatic metastatic melanoma, with response dependent on tumor volume, dose, and fractionation.

Conclusions:

Melanoma's radiation resistance is not absolute; radiation therapy has a defined role.
Radiation therapy improves local control and is valuable for palliation in metastatic melanoma.
Further research, including hyperthermia and experimental strategies, may enhance radiation therapy's utility in melanoma treatment.

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