Abstract
Radiotherapy works by inducing DNA damage in cancer cells, and there are several different methods of radiotherapy delivery including external beam radiotherapy, stereotactic radiosurgery, stereotactic body radiotherapy, radiospheres, brachytherapy, and particle therapy. Historically, melanoma has been deemed a radioresistant tumor, due to early in vitro studies demonstrating a broad shoulder in cell survival curves as well as a high repair rate, inferring a better tumor response with higher radiation doses. For this reason, hypofractionated regimens have become commonplace in the treatment of melanoma given the tolerability, convenience, and low risk of late effects. Nonetheless, in the treatment of primary melanoma, maximal safe surgical resection offers the greatest likelihood of local control. Radiotherapy as a primary treatment is often offered in well-defined situations, such as medical inoperability due to patient comorbidities or tumor location. Clinically, radiation oncologists most frequently see patients with melanoma for consultation in regard to palliation of metastatic disease (for example, stereotactic radiosurgery for brain metastasis or stereotactic body radiotherapy for lung metastasis). The multiple advancements (including technological developments as well as evolution of systemic therapy and immunotherapy) in the treatment of patients with melanoma highlight the importance of multidisciplinary management in this disease.
Keywords
Radiation treatment Stereotactic radiosurgery (SRS) Stereotactic body radiation treatment (SBRT) MelanomaReferences
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