Estimation of an optimal radiotherapy utilization rate for melanoma

Abstract

BACKGROUNDRadiotherapy is not used commonly in the treatment of patients with malignant melanoma. The benchmark optimal radiotherapy utilization rates for melanoma are largely unknown, despite the fact that melanoma is a very common cancer.METHODSTo develop an evidence‐based benchmark for the optimal proportion of patients with melanoma who should receive radiotherapy, the authors reviewed major treatment guidelines for melanoma. A radiotherapy decision tree was constructed showing the clinical features of melanoma patients for whom radiotherapy was indicated based on evidence. The proportions of melanoma patients with indications for radiotherapy were obtained from epidemiologic data and were used to calculate the optimal proportion of melanoma patients who should receive radiotherapy.RESULTSThe proportion of patients with melanoma for whom radiotherapy is indicated at some point in their illness, according to the best available evidence, was calculated at 23% of all melanoma patients. The utilization rates of radiotherapy for melanoma recorded in actual practice were 13% in New South Wales, 6% in data from the American College of Surgeons, and 1% according to Surveillance, Epidemiology, and End Results data.CONCLUSIONSStrategies for implementing the evidence‐based guidelines are recommended to overcome the shortfall in the use of radiotherapy in the treatment of patients with melanoma. Cancer 2004. © 2004 American Cancer Society.

Machine Learning Methodology

“…Detailed algorithm can be consulted in a paper by Freund and Schapire [17] Decision trees have been a popular choice for many decision support systems, especially in the field of medicine, because their representation of hypotheses as sequential "if-then" clauses is easy to interpret and somewhat resembles human reasoning. For example, Delaney et al [13] conducted a literature survey to construct a tree to determine recommendation for radiotherapy to melanoma patients based on several clinical attributes (Fig. 3.7).…”

Radiotherapy with BRAF Inhibitor Therapy for Melanoma: Progress and Possibilities

“…Its application rate is about 51% in patients with AJCC stage IV melanoma compared with only 17% of patients at AJCC stage I-III [41]. Partialbrain radiotherapy or whole-brain radiotherapy is commonly used to treat multiple metastases in the brain either as a sole modality or as an adjuvant treatment following resection, typically up to a total dose of 30 Gy administered in ten fractions.…”

A Role for Proteomics in Identifying Targets for Radiosensitizing Strategies in Melanoma: The FKBP51 Paradigm

“…Although representing about the 3% of all diagnosed skin cancer, melanoma accounts for the 65% of deaths due to skin cancer [2]. Radiation therapy (RT) is a useful component of the therapeutic armamentarium for malignant melanoma, and may be indicated in about a fourth of patients bearing the disease [3]. In fact, RT can ameliorate the local control of locally advanced surgically resected melanoma and to palliate symptoms in the metastatic patients, sometimes slowing the progression of the disease with possible prolongation of survival [4].…”