Skip to main content

Radiotherapy for Distant Metastases

  • Living reference work entry
  • First Online:
Cutaneous Melanoma

Abstract

Radiation therapy (RT) is an important treatment option for patients with metastatic melanoma. RT can provide beneficial palliation for metastatic disease at sites including the brain, bones, spine, and soft tissues. Recent advances in RT techniques such as stereotactic body RT have led to improved precision in treatment delivery, allowing higher dose within the target volume while sparing surrounding normal tissue. This chapter will discuss indications for RT in stage 4 melanoma and the synergy of combining RT with targeted therapy and immune check point inhibitors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Ahmed KA, Abuodeh YA, Echevarria MI, Arrington JA, Stallworth DG, Hogue C, Naghavi AO, Kim S, Kim Y, Patel BG, Sarangkasiri S, Johnstone PA, Sahebjam S, Khushalani NI, Forsyth PA, Harrison LB, Yu M, Etame AB, Caudell JJ (2016). Clinical outcomes of melanoma brain metastases treated with stereotactic radiosurgery and anti-PD-1 therapy, anti-CTLA-4 therapy, BRAF/MEK inhibitors, BRAF inhibitor, or conventional chemotherapy. Ann Oncol 27(12):2288–2294

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ahmed KA, Freilich JM, Sloot S, Figura N, Gibney GT, Weber JS, Sarangkasiri S, Chinnaiyan P, Forsyth PA, Etame AB, Rao NG (2015) LINAC-based stereotactic radiosurgery to the brain with concurrent vemurafenib for melanoma metastases. J Neuro-Oncol 122(1):121–126

    Article  CAS  Google Scholar 

  • Alexander ER, Moriarty T, Davis R, Wen P, Fine H, Black P, Kooy H, Loeffler J (1995) Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Nat Cancer Inst 87(1):34–40

    Article  PubMed  Google Scholar 

  • Anker CJ, Grossmann KF, Atkins MB, Suneja G, Tarhini AA, Kirkwood JM (2016) Avoiding severe toxicity from combined BRAF inhibitor and radiation treatment: consensus guidelines from the eastern cooperative oncology group (ECOG). Int J Radiat Oncol Biol Phys 95(2):632–646

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G (2006a) Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases a randomized controlled trial. JAMA 29(5):2483–2491

    Article  Google Scholar 

  • Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G (2006b) Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 295(21):2483–2491

    Article  CAS  PubMed  Google Scholar 

  • Arbour KC, Mezquita L, Long N, Rizvi H, Auclin E, Ni A, Martinez-Bernal G, Ferrara R, Lai WV, Hendriks LEL, Sabari JK, Caramella C, Plodkowski AJ, Halpenny D, Chaft JE, Planchard D, Riely GJ, Besse B, Hellmann MD (2018) Impact of baseline steroids on efficacy of programmed cell death-1 and programmed death-ligand 1 blockade in patients with non-small-cell lung cancer. J Clin Oncol 36(28):2872–2878

    Article  CAS  PubMed  Google Scholar 

  • Awad R, Fogarty G, Hong A, Kelly P, Ng D, Santos D, Haydu L (2013) Hippocampal avoidance with volumetric modulated arc therapy in melanoma brain metastases – the first Australian experience. Radiat Oncol 8:62

    Article  PubMed  PubMed Central  Google Scholar 

  • Balch CM, Soong SJ, Murad TM, Smith JW, Maddox WA, Durant JR (1983) A multifactorial analysis of melanoma. IV. Prognostic factors in 200 melanoma patients with distant metastases (stage III). J Clin Oncol 1(2):126–134

    Article  CAS  PubMed  Google Scholar 

  • Boehling NS, Grosshans DR, Allen PK, McAleer MF, Burton AW, Azeem S, Rhines LD, Chang EL (2012) Vertebral compression fracture risk after stereotactic body radiotherapy for spinal metastases. J Neurosurg Spine 16(4):379–386

    Article  PubMed  Google Scholar 

  • Breneman J, Warnick R, Albright R, Kukiatinant N, Shaw S, Armin D, Tew J (1997) Stereotactic radiosurgery for the treatment of brain metastases results of a single institution series. Cancer 79(3):551–557

    Article  CAS  PubMed  Google Scholar 

  • Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK, Carrero XW, Barker FG 2nd, Deming R, Burri SH, Menard C, Chung C, Stieber VW, Pollock BE, Galanis E, Buckner JC, Asher AL (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA 316(4):401–409

    Article  PubMed  PubMed Central  Google Scholar 

  • Brown PD, Ballman KV, Cerhan JH, Anderson SK, Carrero XW, Whitton AC, Greenspoon J, Parney IF, Laack NNI, Ashman JB, Bahary JP, Hadjipanayis CG, Urbanic JJ, Barker FG 2nd, Farace E, Khuntia D, Giannini C, Buckner JC, Galanis E, Roberge D (2017) Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC.3): a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol 18(8):1049–1060

    Article  PubMed  PubMed Central  Google Scholar 

  • Chang WS, Kim HY, Chang JW, Park YG, Chang JH (2010) Analysis of radiosurgical results in patients with brain metastases according to the number of brain lesions: is stereotactic radiosurgery effective for multiple brain metastases? J Neurosurg 113(Suppl):73–78

    Article  PubMed  Google Scholar 

  • Choi CY, Chang SD, Gibbs IC, Adler JR, Harsh GRT, Lieberson RE, Soltys SG (2012) Stereotactic radiosurgery of the postoperative resection cavity for brain metastases: prospective evaluation of target margin on tumor control. Int J Radiat Oncol Biol Phys 84(2):336–342

    Article  PubMed  Google Scholar 

  • Choong ES, Lo S, Drummond M, Fogarty GB, Menzies AM, Guminski A, Shivalingam B, Clarke K, Long GV, Hong AM (2017) Survival of patients with melanoma brain metastasis treated with stereotactic radiosurgery and active systemic drug therapies. Eur J Cancer 75:169–178

    Article  CAS  PubMed  Google Scholar 

  • Davies MA, Liu P, McIntyre S, Kim KB, Papadopoulos N, Hwu WJ, Hwu P, Bedikian A (2011) Prognostic factors for survival in melanoma patients with brain metastases. Cancer 117(8):1687–1696

    Article  PubMed  Google Scholar 

  • de la Monte SM, Moore GW, Hutchins GM (1983) Patterned distribution of metastases from malignant melanoma in humans. Cancer Res 43(7):3427–3433

    PubMed  Google Scholar 

  • Du Four S, Hong A, Chan M, Charakidis M, Duerinck J, Wilgenhof S, Wang W, Feng L, Michotte A, Okera M, Shivalingam B, Fogarty G, Kefford R, Neyns B (2014) Symptomatic histologically proven necrosis of brain following stereotactic radiation and Ipilimumab in six lesions in four melanoma patients. Case Rep Oncol Med 2014:417913

    PubMed  PubMed Central  Google Scholar 

  • Epstein-Peterson ZD, Sullivan A, Krishnan M, Chen JT, Ferrone M, Ready J, Baldini EH, Balboni T (2015) Postoperative radiation therapy for osseous metastasis: outcomes and predictors of local failure. Pract Radiat Oncol 5(5):e531–e536

    Article  PubMed  Google Scholar 

  • Escorcia FE, Postow MA, Barker CA (2017) Radiotherapy and immune checkpoint blockade for melanoma: a promising combinatorial strategy in need of further investigation. Cancer J 23(1):32–39

    Article  PubMed  PubMed Central  Google Scholar 

  • Ewend M, Morris D, Carey L, Ladha A, Brem S (2008) Guidelines for the initial management of metastatic brain tumors: role of surgery, radiosurgery, and radiation therapy. J Nat Compr Cancer Netw 6(5):505–514

    Article  Google Scholar 

  • Fogarty GB, Hong A, Dolven-Jacobsen K, Reisse CH, Burmeister B, Haydu LH, Dhillon H, Steel V, Shivalingam B, Drummond K, Vardy J, Nowak A, Hruby G, Scolyer RA, Mandel C, Thompson JF (2015) First interim analysis of a randomised trial of whole brain radiotherapy in melanoma brain metastases confirms high data quality. BMC Res Notes 8:192

    Article  PubMed  PubMed Central  Google Scholar 

  • Franceschini D, Franzese C, De Rose F, Navarria P, D’Agostino GR, Comito T, Tozzi A, Tronconi MC, Di Guardo L, Del Vecchio M, Scorsetti M (2017) Role of extracranial stereotactic body radiation therapy in the management of stage IV melanoma. Br J Radiol 90(1077):20170257

    Article  PubMed  PubMed Central  Google Scholar 

  • Gerszten PC, Burton SA, Ozhasoglu C, Welch WC (2007) Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine (Phila Pa 1976) 32(2):193–199

    Article  Google Scholar 

  • Gomez DR, Blumenschein GR Jr, Lee JJ, Hernandez M, Ye R, Camidge DR, Doebele RC, Skoulidis F, Gaspar LE, Gibbons DL, Karam JA, Kavanagh BD, Tang C, Komaki R, Louie AV, Palma DA, Tsao AS, Sepesi B, William WN, Zhang J, Shi Q, Wang XS, Swisher SG, Heymach JV (2016) Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol 17(12):1672–1682

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gondi V, Tolakanahalli R, Mehta MP, Tewatia D, Rowley H, Kuo JS, Khuntia D, Tome WA (2010a) Hippocampal-sparing whole-brain radiotherapy: a “how-to” technique using helical tomotherapy and linear accelerator-based intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 78(4):1244–1252

    Article  PubMed  PubMed Central  Google Scholar 

  • Gondi V, Tome WA, Mehta MP (2010b) Why avoid the hippocampus? A comprehensive review. Radiother Oncol 97(3):370–376

    Article  PubMed  PubMed Central  Google Scholar 

  • Gondi V, Pugh SL, Tome WA, Caine C, Corn B, Kanner A, Rowley H, Kundapur V, DeNittis A, Greenspoon JN, Konski AA, Bauman GS, Shah S, Shi W, Wendland M, Kachnic L, Mehta MP (2014) Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933): a phase II multi-institutional trial. J Clin Oncol 32(34):3810–3816

    Article  PubMed  PubMed Central  Google Scholar 

  • Gondi V, Deshmukh S, Brown PD, Wefel JS, Tome WA, Bruner DW, Bovi JA, Robinson CG, Khuntia D, Grosshans DR, Konski AA, Roberge D, Kundapur V, Devisetty K, Shah A, Usuki KY, Anderson BM, Mehta M, Kachnic L (2018) Preservation of neurocognitive function (NCF) with conformal avoidance of the hippocampus during whole-brain radiotherapy (HA-WBRT) for brain metastases: preliminary results of phase III trial NRG oncology CC001. Int J Radiat Oncol Biol Phys 102(5):1607

    Article  Google Scholar 

  • Guckenberger M, Mantel F, Gerszten PC, Flickinger JC, Sahgal A, Letourneau D, Grills IS, Jawad M, Fahim DK, Shin JH, Winey B, Sheehan J, Kersh R (2014) Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis. Radiat Oncol 9:226

    Article  PubMed  PubMed Central  Google Scholar 

  • Hadden NJ, McIntosh JRD, Jay S, Whittaker PJ (2018) Prognostic factors in patients with metastatic spinal cord compression secondary to melanoma: a systematic review. Melanoma Res 28(1):1–7

    Article  PubMed  Google Scholar 

  • Hasegawa T, Kondziolka D, Flickinger JC, Germanwala A, Lunsford LD (2003) Brain metastases treated with radiosurgery alone: an alternative to whole brain radiotherapy? Neurosurgery:1318–1326

    Google Scholar 

  • Henderson MA, Burmeister BH, Ainslie J, Fisher R, Di Iulio J, Smithers BM, Hong A, Shannon K, Scolyer RA, Carruthers S, Coventry BJ, Babington S, Duprat J, Hoekstra HJ, Thompson JF (2015) Adjuvant lymph-node field radiotherapy versus observation only in patients with melanoma at high risk of further lymph-node field relapse after lymphadenectomy (ANZMTG 01.02/TROG 02.01): 6-year follow-up of a phase 3, randomised controlled trial. Lancet Oncol 16(9):1049–1060

    Article  PubMed  Google Scholar 

  • Herbert SH, Solin LJ, Rate WR, Schultz DJ, Hanks GE (1991) The effect of palliative radiation therapy on epidural compression due to metastatic malignant melanoma. Cancer 67(10):2472–2476

    Article  CAS  PubMed  Google Scholar 

  • Hiniker SM, Reddy SA, Maecker HT, Subrahmanyam PB, Rosenberg-Hasson Y, Swetter SM, Saha S, Shura L, Knox SJ (2016) A prospective clinical trial combining radiation therapy with systemic immunotherapy in metastatic melanoma. Int J Radiat Oncol Biol Phys 96(3):578–588

    Article  PubMed  PubMed Central  Google Scholar 

  • Hong AM, Suo C, Valenzuela M, Haydu LE, Jacobsen KD, Reisse CH, Fogarty G (2014) Low incidence of melanoma brain metastasis in the hippocampus. Radiother Oncol 111(1):59–62

    Article  PubMed  Google Scholar 

  • Huguenin PU, Kieser S, Glanzmann C, Capaul R, Lutolf UM (1998) Radiotherapy for metastatic carcinomas of the kidney or melanomas: an analysis using palliative end points. Int J Radiat Oncol Biol Phys 41(2):401–405

    Article  CAS  PubMed  Google Scholar 

  • Iyengar P, Wardak Z, Gerber DE, Tumati V, Ahn C, Hughes RS, Dowell JE, Cheedella N, Nedzi L, Westover KD, Pulipparacharuvil S, Choy H, Timmerman RD (2018) Consolidative radiotherapy for limited metastatic non-small-cell lung cancer: a phase 2 randomized clinical trial. JAMA Oncol 4(1):e173501

    Article  PubMed  Google Scholar 

  • Khmelevsky EV, Bychkova NM (2015) Radiosensitivity of bone metastases from tumors in different primary sites. Vopr Onkol 61(1):77–84

    CAS  PubMed  Google Scholar 

  • Kocher M, Soffietti R, Abacioglu U, Villa S, Fauchon F, Baumert BG, Fariselli L, Tzuk-Shina T, Kortmann RD, Carrie C, Ben Hassel M, Kouri M, Valeinis E, van den Berge D, Collette S, Collette L, Mueller RP (2011) Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952–26001 study. J Clin Oncol 29(2):134–141

    Article  PubMed  Google Scholar 

  • Kohutek ZA, Yamada Y, Chan TA, Brennan CW, Tabar V, Gutin PH, Yang TJ, Rosenblum MK, Ballangrud A, Young RJ, Zhang Z, Beal K (2015) Long-term risk of radionecrosis and imaging changes after stereotactic radiosurgery for brain metastases. J Neurooncol 125(1):149–156

    Article  PubMed  PubMed Central  Google Scholar 

  • Konefal JB, Emami B, Pilepich MV (1988) Analysis of dose fractionation in the palliation of metastases from malignant melanoma. Cancer 61(2):243–246

    Article  CAS  PubMed  Google Scholar 

  • Krygier JE, Lewis VO, Cannon CP, Satcher RL, Moon BS, Lin PP (2014) Operative management of metastatic melanoma in bone may require en bloc resection of disease. Clin Orthop Relat Res 472(10):3196–3203

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee MT, Kim JJ, Dinniwell R, Brierley J, Lockwood G, Wong R, Cummings B, Ringash J, Tse RV, Knox JJ, Dawson LA (2009a) Phase I study of individualized stereotactic body radiotherapy of liver metastases. J Clin Oncol 27(10):1585–1591

    Article  PubMed  Google Scholar 

  • Lee Y, Auh SL, Wang Y, Burnette B, Wang Y, Meng Y, Beckett M, Sharma R, Chin R, Tu T, Weichselbaum RR, Fu YX (2009b) Therapeutic effects of ablative radiation on local tumor require CD8+ T cells: changing strategies for cancer treatment. Blood 114(3):589–595

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Leksell L (1949) The stereotaxic method and radiosurgery of the brain. Acta Chir Scand 102(4):316–319

    Google Scholar 

  • Liew DN, Kano H, Kondziolka D, Mathieu D, Niranjan A, Flickinger JC, Kirkwood JM, Tarhini A, Moschos S, Lunsford LD (2011) Outcome predictors of gamma knife surgery for melanoma brain metastases. Clinical article. J Neurosurg 114(3):769–779

    Article  PubMed  Google Scholar 

  • Ling DC, Vargo JA, Wegner RE, Flickinger JC, Burton SA, Engh J, Amankulor N, Quinn AE, Ozhasoglu C, Heron DE (2015) Postoperative stereotactic radiosurgery to the resection cavity for large brain metastases: clinical outcomes, predictors of intracranial failure, and implications for optimal patient selection. Neurosurgery 76(2):150–156; discussion 156–157; quiz 157

    Article  PubMed  Google Scholar 

  • Liniker E, Menzies AM, Kong BY, Cooper A, Ramanujam S, Lo S, Kefford RF, Fogarty GB, Guminski A, Wang TW, Carlino MS, Hong A, Long GV (2016) Activity and safety of radiotherapy with anti-PD-1 drug therapy in patients with metastatic melanoma. Oncoimmunology 5(9):e1214788

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mahajan A, Ahmed S, McAleer MF, Weinberg JS, Li J, Brown P, Settle S, Prabhu SS, Lang FF, Levine N, McGovern S, Sulman E, McCutcheon IE, Azeem S, Cahill D, Tatsui C, Heimberger AB, Ferguson S, Ghia A, Demonte F, Raza S, Guha-Thakurta N, Yang J, Sawaya R, Hess KR, Rao G (2017) Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial. Lancet Oncol

    Google Scholar 

  • Martin AM, Cagney DN, Catalano PJ, Alexander BM, Redig AJ, Schoenfeld JD, Aizer AA (2018) Immunotherapy and symptomatic radiation necrosis in patients with brain metastases treated with stereotactic radiation. JAMA Oncol 4(8):1123–1124

    Article  PubMed  PubMed Central  Google Scholar 

  • Mathieu D, Kondziolka D, Cooper PB, Flickinger JC, Niranjan A, Agarwala S, Kirkwood J, Lunsford LD (2007) Gamma knife radiosurgery in the management of malignant melanoma brain metastases. Neurosurgery 60(3):471–481; discussion 481–472

    Article  PubMed  Google Scholar 

  • Minniti G, Clarke E, Lanzetta G, Osti MF, Trasimeni G, Bozzao A, Romano A, Enrici RM (2011) Stereotactic radiosurgery for brain metastases: analysis of outcome and risk of brain radionecrosis. Radiat Oncol 6:48

    Google Scholar 

  • Monje ML, Mizumatsu S, Fike JR, Palmer TD (2002) Irradiation induces neural precursor-cell dysfunction. Nat Med 8(9):955–962

    Article  CAS  PubMed  Google Scholar 

  • Mornex F, Thomas L, Mohr P, Hauschild A, Delaunay MM, Lesimple T, Tilgen W, Bui BN, Guillot B, Ulrich J, Bourdin S, Mousseau M, Cupissol D, Bonneterre ME, De Gislain C, Bensadoun RJ, Clavel M (2003) A prospective randomized multicentre phase III trial of fotemustine plus whole brain irradiation versus fotemustine alone in cerebral metastases of malignant melanoma. Melanoma Res 13(1):97–103

    Article  CAS  PubMed  Google Scholar 

  • Pires da Silva I, Glitza IC, Haydu LE, Johnpulle R, Banks PD, Grass GD, Goldinger SMA, Smith JL, Everett AS, Koelblinger P, Roberts-Thomson R, Millward M, Atkinson VG, Guminski A, Kapoor R, Conry RM, Carlino MS, Wang W, Shackleton MJ, Eroglu Z, Lo S, Hong AM, Long GV, Johnson DB, Menzies AM (2019) Incidence, features and management of radionecrosis in melanoma patients treated with cerebral radiotherapy and anti-PD-1 antibodies. Pigment Cell Melanoma Res 32(4):553–563

    Article  CAS  Google Scholar 

  • Pulvirenti T, Hong A, Clements A, Forstner D, Suchowersky A, Guminski A, McNeil C, Hersey P, Fogarty G, Kefford R, Long GV, Wang W (2016) Acute radiation skin toxicity associated with BRAF inhibitors. J Clin Oncol 34(3):e17–e20

    Article  PubMed  Google Scholar 

  • Raber J, Rola R, LeFevour A, Morhardt D, Curley J, Mizumatsu S, VandenBerg SR, Fike JR (2004) Radiation-induced cognitive impairments are associated with changes in indicators of hippocampal neurogenesis. Radiat Res 162(1):39–47

    Article  CAS  PubMed  Google Scholar 

  • Rades D, Huttenlocher S, Bajrovic A, Karstens JH, Adamietz IA, Kazic N, Rudat V, Schild SE (2011) Surgery followed by radiotherapy versus radiotherapy alone for metastatic spinal cord compression from unfavorable tumors. Int J Radiat Oncol Biol Phys 81(5):e861–e868

    Article  PubMed  Google Scholar 

  • Rate WR, Solin LJ, Turrisi AT (1988) Palliative radiotherapy for metastatic malignant melanoma: brain metastases, bone metastases, and spinal cord compression. Int J Radiat Oncol Biol Phys 15(4):859–864

    Article  CAS  PubMed  Google Scholar 

  • Redmond KJ, Mahone EM, Terezakis S, Ishaq O, Ford E, McNutt T, Kleinberg L, Cohen KJ, Wharam M, Horska A (2013) Association between radiation dose to neuronal progenitor cell niches and temporal lobes and performance on neuropsychological testing in children: a prospective study. Neuro-Oncology 15(3):360–369

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rich SE, Chow R, Raman S, Liang Zeng K, Lutz S, Lam H, Silva MF, Chow E (2018) Update of the systematic review of palliative radiation therapy fractionation for bone metastases. Radiother Oncol 126(3):547–557

    Article  PubMed  Google Scholar 

  • Rose PS, Laufer I, Boland PJ, Hanover A, Bilsky MH, Yamada J, Lis E (2009) Risk of fracture after single fraction image-guided intensity-modulated radiation therapy to spinal metastases. J Clin Oncol 27(30):5075–5079

    Article  PubMed  PubMed Central  Google Scholar 

  • Rusthoven KE, Kavanagh BD, Cardenes H, Stieber VW, Burri SH, Feigenberg SJ, Chidel MA, Pugh TJ, Franklin W, Kane M, Gaspar LE, Schefter TE (2009) Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol 27(10):1572–1578

    Article  PubMed  Google Scholar 

  • Sambade MJ, Peters EC, Thomas NE, Kaufmann WK, Kimple RJ, Shields JM (2011) Melanoma cells show a heterogeneous range of sensitivity to ionizing radiation and are radiosensitized by inhibition of B-RAF with PLX-4032. Radiother Oncol 98(3):394–399

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Samstein RM, Budhu S, Mergoub T, Barker C (2017) Combining radiotherapy and immunotherapy: emerging preclinical observations of lymphocyte costimulatory and inhibitory receptor modulation. In: Tofilon P, Camphausen K (eds) Incresaing the therapeutic ratio of radiotherapy. Cancer Drug Discovery and Development. Humana Press, Cham, pp 151–169

    Google Scholar 

  • Sause WT, Cooper JS, Rush S, Ago CT, Cosmatos D, Coughlin CT, JanJan N, Lipsett J (1991) Fraction size in external beam radiation therapy in the treatment of melanoma. Int J Radiat Oncol Biol Phys 20(3):429–432

    Article  CAS  PubMed  Google Scholar 

  • Schick U, Kyula J, Barker H, Patel R, Zaidi S, Gregory C, Hafsi H, Roulstone V, Deutsch E, McLaughlin M, Harrington K (2015) Trametinib radiosensitises RAS- and BRAF-mutated melanoma by perturbing cell cycle and inducing senescence. Radiother Oncol 117(2):364–375

    Article  CAS  PubMed  Google Scholar 

  • Seeley AR, De Los Santos JF, Conry RM (2015) Induction vemurafenib followed by consolidative radiation therapy for surgically incurable melanoma. Melanoma Res 25(3):246–251

    Article  CAS  PubMed  Google Scholar 

  • Seung SK, Curti BD, Crittenden M, Walker E, Coffey T, Siebert JC, Miller W, Payne R, Glenn L, Bageac A, Urba WJ (2012) Phase 1 study of stereotactic body radiotherapy and interleukin-2--tumor and immunological responses. Sci Transl Med 4(137):137ra174

    Article  CAS  Google Scholar 

  • Sharabi AB, Nirschl CJ, Kochel CM, Nirschl TR, Francica BJ, Velarde E, Deweese TL, Drake CG (2015) Stereotactic radiation therapy augments antigen-specific PD-1-mediated antitumor immune responses via cross-presentation of tumor antigen. Cancer Immunol Res 3(4):345–355

    Article  CAS  PubMed  Google Scholar 

  • Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, Farnan N (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90–05. Int J Radiat Oncol Biol Phys 47(2):291–298

    Article  CAS  PubMed  Google Scholar 

  • Shehata M, Young B, Reid B, Patchell R, Clair WS, Sims J, Sanders M, Meigooni A, Mohiuddin M, Regine W (2004) Stereotatic radiosurgery of 468 brain metastases < or =2 cm: implications for SRS dose and whole brain radiation therapy. Int J Radiat Oncol Biol Phys 59(1):87–93

    Article  PubMed  Google Scholar 

  • Shiau C, Sneed P, Shu H, KR L, McDermott M, Chang S, Nowak P, Petti P, Smith V, Verhey L, Ho L, Park E, Wara W, Gutin PH, Larson D (1997) Radiosurgery for brain metastases: relationship of dose and patterns of enhancement to local control. Int J Radiat Oncol Biol Phys 37(2):375–383

    Article  CAS  PubMed  Google Scholar 

  • Shibaki R, Akamatsu H, Fujimoto M, Koh Y, Yamamoto N (2017) Nivolumab induced radiation recall pneumonitis after two years of radiotherapy. Ann Oncol 28(6):1404–1405

    Article  CAS  PubMed  Google Scholar 

  • Siva S, MacManus M, Ball D (2010) Stereotactic radiotherapy for pulmonary oligometastases: a systematic review. J Thorac Oncol 5(7):1091–1099

    Article  PubMed  Google Scholar 

  • Sneed P, Lamborn K, Forstner J, McDermott M, Chang S, Park E, Gutin P, Phillips T, Wara W, Larson D (1999) Radiosurgery for brain metastases: is whole brain radiotherapy really necessary. Int J Radiat Oncol Biol Phys 43(3):549–558

    Article  CAS  PubMed  Google Scholar 

  • Spratt DE, Beeler WH, de Moraes FY, Rhines LD, Gemmete JJ, Chaudhary N, Shultz DB, Smith SR, Berlin A, Dahele M, Slotman BJ, Younge KC, Bilsky M, Park P, Szerlip NJ (2017) An integrated multidisciplinary algorithm for the management of spinal metastases: an international spine oncology consortium report. Lancet Oncol 18(12):e720–e730

    Article  PubMed  Google Scholar 

  • Wang XS, Rhines LD, Shiu AS, Yang JN, Selek U, Gning I, Liu P, Allen PK, Azeem SS, Brown PD, Sharp HJ, Weksberg DC, Cleeland CS, Chang EL (2012) Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1–2 trial. Lancet Oncol 13(4):395–402

    Article  PubMed  PubMed Central  Google Scholar 

  • Wedin R, Falkenius J, Weiss RJ, Hansson J (2012) Surgical treatment of skeletal metastases in 31 melanoma patients. Acta Orthop Belg 78(2):246–253

    PubMed  Google Scholar 

  • Yamada Y, Katsoulakis E, Laufer I, Lovelock M, Barzilai O, McLaughlin LA, Zhang Z, Schmitt AM, Higginson DS, Lis E, Zelefsky MJ, Mechalakos J, Bilsky MH (2017) The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery. Neurosurg Focus 42(1):E6

    Article  PubMed  PubMed Central  Google Scholar 

  • Youland RS, Blanchard ML, Dronca R, Kottschade L, Markovic SN, Olivier KR, Park SS (2017) Role of radiotherapy in extracranial metastatic malignant melanoma in the modern era. Clin Transl Radiat Oncol 6:25–30

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhao Z, Wang S, Barber BL (2014) Treatment patterns in patients with metastatic melanoma: a retrospective analysis. J Skin Cancer 2014:371326

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angela M. Hong .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Hong, A.M., Barker, C.A. (2019). Radiotherapy for Distant Metastases. In: Balch, C., et al. Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-46029-1_31-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-46029-1_31-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46029-1

  • Online ISBN: 978-3-319-46029-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics