Abstract
Surgery is the mainstay of treatment for localized melanoma. Postoperative radiation therapy after lymphadenectomy has shown to provide an excellent locoregional control in patients with melanoma node metastases with high risk for loco-regional relapse (lymph nodes ≥ 3 cm, ≥ 3 lymph nodes involved, extracapsular extension and/or recurrent disease). In patients with brain metastases from malignant melanoma whole brain irradiation remains a recommended treatment in terms of symptom palliation, especially when extra-cranial systemic disease is present. Different schedules of total dose and fractionation (20 Gy/5 fractions vs 30 Gy/10 fractions) have been used. The results suggest that median survival lime was not significantly affected by the total dose I fractionation schedule. Concerning the role of temozolomide (TMZ) in preventing central nervous system relapses in patients with advanced melanoma responding to systemic therapy, the results of the studies do not support a clear benefit of TMZ in preventing cerebral relapse, nor in terms of time to cerebral progression. In patients with long-term survival, necrosis and cognitive dysfunction due to leukoencephalopathy are the main delayed complications of brain irradiation. Radiation induced leukoencephalopathy is greater in patients with pre-existing leukoaraiosis. Because of the potential of long-term survival in a small subset of patients with brain metastases and the risk of radiation-induced dementia, neurotoxicity reduction in patients with leukoaraiosis is an important goal of treatment.
| Translated title of the contribution | Role of radiotherapy in skin cancer melanoma |
|---|---|
| Original language | Spanish |
| Pages (from-to) | 216-224 |
| Number of pages | 9 |
| Journal | Revisiones en Cancer |
| Volume | 25 |
| Issue number | 5 |
| State | Published - 2011 |
Keywords
- Brain metastases
- Leukoencephalopathy
- Melanoma
- Nodal metastases
- Radiation therapy
- Radiation toxicity
ASJC Scopus subject areas
- Oncology