Radiotherapy of Malignant Melanoma

Abstract

The reason why malignant melanoma is considered as a radioresistant tumor is not clear. As early as 1939 Ellis (1) described the definite response to radiation of 12 melanomas at different sites. Since then several authors have reported the succesful use of radiation in melanoma (2,3,4,5,6,7,8). Two possible explanations of the unbelief in radiotherapy are the infrequent referral in this mainly surgically treated disease (1) or the extremely slow regression rate that is sometimes seen after radiation and that has been interpreted as radioresistance (7). Reading the literature on radiotherapy of melanoma is not easy, because sometimes cutaneous and other melanomas are grouped together and within the group of cutaneous melanoma irradiation has been used for the primary tumor, post-operatively, for local recurrence, for regional lymph node metastases and for distant metastases in skin, bone or brain. Within the group of cutaneous melanomas the radiosensibility varies from very good (for lentigo maligna melanoma) to good (for superficial spreading melanoma) to fair (for nodular melanoma) (8,21). All types of irradiation have been used, like external beams (X rays or electrons), superficial applicators, interstitial needles or seeds.