Radiation Therapy of Melanomas

  • Renato G. Panizzon


Although surgery is by far the most common form of treatment for most cutaneous melanomas, there are some limited indications for radiation therapy. Irradiation has a definitive role in the treatment of lentigo maligna (LM), especially with grenz rays. For lentigo maligna melanomas (LMM), more penetrating soft x rays show great promise as a curative treatment modality.1–3 Therapeutic trials with radiotherapy of inoperable nonlentiginous melanomas and of metastatic lesions to skin or lymph nodes have shown that these lesions are less responsive to ionizing radiation. The results of numerous clinical investigations favor techniques that utilize high doses per fraction (the term “high dose” fraction is used in this connection, in contrast to the low standard 200-cGy fractions used in radiation oncology). In patients treated with curative intent, either definitively or adjunctively, the difference between high-dose fractions and low- dose fractions may be decisive. More prospective trials are needed to test the reported greater efficacy of high doses. Late complications associated with high dose per fraction irradiation are not a relevant risk in patients with metastatic melanoma where survival is generally limited. The use of high doses per fraction is not really new; radiotherapy of melanoma has a long tradition in our institution since Miescher first introduced it several decades ago.3


Melanoma Cell Dose Recommendation Cutaneous Melanoma Nodular Melanoma Superficial Spreading Melanoma 
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© Springer-Verlag New York Inc. 1991

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  • Renato G. Panizzon

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