Regional Radiotherapy as Adjuvant Treatment for Head and Neck Malignant Melanoma: Preliminary Results

Ang, K. Kian; Byers, Robert M.; Peters, Lester J.; Maor, Moshe; Wendt, Charles D.; Morrison, William H.; Hussey, David H.; Goepfert, Helmuth

doi:10.1001/archotol.1990.01870020045012

Cited by 119 publications

(51 citation statements)

References 11 publications

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“…Most patients who were treated earlier in the series (1996-2000) received 33 grays (Gy) in 6 fractions twice weekly, reflecting the popularity of hypofractionated regimes for melanoma at that time. 15 Patients who were treated after 2000 generally received more conventional schedules using 2 to 2.4 Gy per fraction per day.…”

Section: Resultsmentioning

confidence: 99%

Desmoplastic neurotropic melanoma

Chen

Hruby

Scolyer

et al. 2008

Cancer

130

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BACKGROUND.Several studies have suggested that desmoplastic neurotropic melanoma (DNM) is associated with higher local recurrence rates than other types of melanoma. The authors investigated the local recurrence rates for patients with DNM after surgery alone or surgery followed by radiotherapy (RT).METHODS.One hundred twenty‐eight patients with DNM were treated at the Sydney Melanoma Unit and the Sydney Cancer Center from 1996 to 2007. All patients underwent local excision, 27 patients also received RT. For both groups, clinical and pathologic features, treatment details, and local recurrence data were analyzed.RESULTS.The median age at diagnosis was 65.5 years. The ratio of men to women was 2.7:1. The head and neck was the most common location (51%). The median Breslow thickness was 4 mm, and 99% of patients had Clark Level IV or V primary tumors. Patients who received adjuvant RT had thicker tumors (P = .003), deeper Clark level invasion (P < .001), and narrower excision margins (P < .001). There were 8 local recurrences, including 6 (6%) in the surgery only group and 2 (7%) in the adjuvant RT group. A positive margin (P < .001) and head and neck location (P = .03) were significant predictors of local recurrence.CONCLUSIONS.The local recurrence rate in this series was lower than the rates reported in historic control groups and in the authors' previous temporal cohort. The results indicated that clear surgical margins are of paramount importance in minimizing local recurrence; when margins are compromised, the addition of RT may reduce local recurrence rates compared with historic controls. A prospective randomized trial is needed to quantify the risk reduction with adjuvant RT. Cancer 2008. © 2008 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

Desmoplastic neurotropic melanoma

Chen

Hruby

Scolyer

et al. 2008

Cancer

130

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“…27 There has been a dogma that malignant melanoma is radioresistant. 27,45 Some in vitroradiobiological 4 and clinical studies, 2,19,27,36,39,41,46,[52][53] however, have demonstrated that radiotherapy may have a beneficial effect in locoregional control. The clinical studies were based on the in vitroinvestigation by Barranco 4 , which revealed a large, curvy shoulder with a relatively steep terminal slope in the survival curves of three human melanoma cell lines.…”

Section: Introductionmentioning

confidence: 99%

“…2,19,41,[52][53] Different fractionation schedules have been used, e.g. 5 x 6 Gy twice a week 2 , 8 x 5 Gy/twice a week, 41 or 4 x 8 Gy once-a-week.…”

Section: Introductionmentioning

confidence: 99%

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Malignant mucosal melanoma of the head and neck — a review

Lengyel

Gilde

Remenár

et al. 2003

Pathol. Oncol. Res.

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“…Because adjuvant INFa-2b [47][48][49] and RT 50,51 are commonly used after surgery for high-risk melanoma, the combination has been tested in patients at significant risk for lymph node and distant relapse. In one such phase 1/2 study, after induction IFNa-2b, 23 patients received 30 Gy in 5 twice-weekly fractions in addition to concurrent IFNa-2b.…”

Section: Early Clinical Outcomes With Immunotherapies and Rtmentioning

confidence: 99%

Irradiation and immunotherapy: From concept to the clinic

Salama

Postow

Salama

2016

Cancer

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In recent years, an increased understanding of T‐cell–regulatory mechanisms has led to the development of a novel class of immune‐checkpoint inhibitors that have robust clinical activity against a broad array of malignancies—even those that historically were not believed to be sensitive to immune therapy. With this, there has been renewed interest in the potential for synergy with more traditional forms of anticancer therapy like radiation therapy (RT). The role of RT in palliation or as definitive treatment for certain malignancies has been well established. Yet, in recent years, the concept has come to light that RT could be an attractive partner for use in combination with other immunotherapies. The effects of RT include not only control of an irradiated tumor but also multiple immunomodulatory effects on both the tumor and the microenvironment, priming tumors for an immune‐mediated response. Herein, the authors summarize relevant preclinical data and rationale supporting the synergy of combined RT and immunotherapy and highlight recent clinical work on promising combination strategies. Cancer 2016;122:1659‐71. © 2016 American Cancer Society.

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Regional Radiotherapy as Adjuvant Treatment for Head and Neck Malignant Melanoma: Preliminary Results

Cited by 119 publications

References 11 publications

Desmoplastic neurotropic melanoma

Desmoplastic neurotropic melanoma

Malignant mucosal melanoma of the head and neck — a review

Irradiation and immunotherapy: From concept to the clinic

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