Practical Considerations in Metastatic Melanoma - Episode 5

Role of Adjuvant Radiation Therapy in Melanoma

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Adjuvant radiation therapy reduces the risk of local recurrence in patients with high-risk melanoma, notes Robert H. I. Andtbacka, MD, CM. However, this benefit does not translate into an extension in overall survival or control of distant recurrences. Additionally, Andtbacka notes, radiation therapy is accompanied by increased locoregional symptoms, with areas of the head and neck being less impacted compared with the groin.

If wound healing is sluggish as a result of obesity or other condition, radiation should not be considered, suggests Jeffrey A. Sosman, MD. Additionally, as a result of the added toxicity, treatment selection should focus on the patient’s health and the presences of extracapsular extension. However, even when extracapsular extensions are present, Andtbacka advises against radiation to groin areas.

In the ECOG-1609 trial, adjuvant ipilimumab is being compared with high-dose interferon alfa-2b in patients with high-risk stage III-IV melanoma. In this trial, enrollment does not exclude previous adjuvant radiation therapy, notes Omid Hamid, MD. As a result, findings from this study will provide further information on long-term outcomes with radiation therapy.