Role of postoperative irradiation for patients with bilateral cervical nodal metastases from cutaneous melanoma: a critical assessment.
BACKGROUND
The aim of this study was to evaluate the role of regional nodal radiation therapy (RT) for patients with bilateral cervical nodal metastases from melanoma.


METHODS
Between 1998 and 2008, 16 patients with bilateral cervical metastases without distant metastases were treated with postoperative RT (30 Gy in 5 fractions delivered twice weekly).


RESULTS
Median follow-up was 5 months (range, 1-34 months). Median survival was 9 months (95% confidence interval [CI], 0-23 months). Overall survival was 68%, 50%, and 27% at 6, 12, and 24 months, respectively. Regional nodal control was 74% and 64% at 6 and 12 months, respectively. Rates of development of distant metastasis were 60%, 70%, and 90% at 6, 12, and 18 months, respectively. The actuarial rate of RT-related complications was 49% at 12 months.


CONCLUSIONS
The limited life expectancy of patients observed with this disease combined with the high rate of RT-related complications argue against the routine use of adjuvant RT for regional nodal disease in this setting.
Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. aguadagn@mdanderson.org
B Ashleigh
BA
Guadagnolo
Jeffrey N
JN
Myers
Gunar K
GK
Zagars
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D011182:Postoperative Care; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D055815:Young Adult