title: A prospective phase II study of adjuvant postoperative radiation therapy following nodal surgery in malignant melanoma-Trans Tasman Radiation Oncology Group (TROG) Study 96.06.
abstract: BACKGROUND
  The role of adjuvant postoperative therapy after resection of localised malignant melanoma involving regional lymph nodes remains controversial. There are no randomised trials that confirm that postoperative radiation conveys a benefit in terms of regional control or survival.
  
  
  METHODS
  Two hundred and thirty-four patients with melanoma involving lymph nodes were registered on a prospective study to evaluate the effect of postoperative radiation therapy. The regimen consisted of 48Gy in 20 fractions to the nodal basin using recommended treatment guidelines for each of the major node sites. The primary endpoints were regional in-field relapse and late toxicity. Secondary endpoints were adjacent relapse, distant relapse, overall survival, progression-free survival and time to in-field progression.
  
  
  RESULTS
  Adjuvant radiation therapy was well tolerated by all of the patients. As the first site of relapse, regional in-field relapses occurred in 16/234 patients (6.8%). The overall survival was 36% at 5 years. The progression-free survival and regional control rates were 27% and 91%, respectively, at 5 years. Patients with more than 2 nodes involved had a significantly worse outcome in terms of distant relapse, overall and progression-free survival.
  
  
  CONCLUSIONS
  We believe that adjuvant radiation therapy following nodal surgery could offer a possible benefit in terms of regional control. These results require confirmation in a randomised trial.
authors.affiliation: University of Queensland, Melanoma Clinic, Princess Alexandra Hospital, Brisbane, Australia. Bryan_Burnmeister@health.qld.gov.au
authors.forename: Bryan H
authors.initials: BH
authors.lastname: Burmeister
authors.forename: B
authors.initials: B
authors.lastname: Mark Smithers
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Burmeister
authors.forename: Kathryn
authors.initials: K
authors.lastname: Baumann
authors.forename: Sidney
authors.initials: S
authors.lastname: Davis
authors.forename: Hedley
authors.initials: H
authors.lastname: Krawitz
authors.forename: Carol
authors.initials: C
authors.lastname: Johnson
authors.forename: Nigel
authors.initials: N
authors.lastname: Spry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D011182:Postoperative Care; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D016896:Treatment Outcome