title: Adjuvant radiation therapy in metastatic lymph nodes from melanoma.
abstract: OBJECTIVE
  To analyze the outcome after adjuvant radiation therapy with standard fractionation regimen in metastatic lymph nodes (LN) from cutaneous melanoma.
  
  
  METHODS
  86 successive patients (57 men) were treated for locally advanced melanoma in our institution. 60 patients (69%) underwent LN dissection followed by radiation therapy (RT), while 26 patients (31%) had no radiotherapy.
  
  
  RESULTS
  The median number of resected LN was 12 (1 to 36) with 2 metastases (1 to 28). Median survival after the first relapse was 31.8 months. Extracapsular extension was a significant prognostic factor for regional control (p = 0.019). Median total dose was 50 Gy (30 to 70 Gy). A standard fractionation regimen was used (2 Gy/fraction). Median number of fractions was 25 (10 to 44 fractions). Patients were treated with five fractions/week. Patients with extracapsular extension treated with surgery followed by RT (total dose ≥50 Gy) had a better regional control than patients treated by surgery followed by RT with a total dose <50 Gy (80% vs. 35% at 5-year follow-up; p = 0.004).
  
  
  CONCLUSIONS
  Adjuvant radiotherapy was able to increase regional control in targeted sub-population (LN with extracapsular extension).
authors.affiliation: Academic Radiotherapy Departement, CLCC Oscar Lambret Comprehensive Cancer Center, Lille-Nord de France University, Lille, France. jebibault@gmail.com
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Bibault
authors.forename: Sylvain
authors.initials: S
authors.lastname: Dewas
authors.forename: Xavier
authors.initials: X
authors.lastname: Mirabel
authors.forename: Laurent
authors.initials: L
authors.lastname: Mortier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Penel
authors.forename: Luc
authors.initials: L
authors.lastname: Vanseymortier
authors.forename: Eric
authors.initials: E
authors.lastname: Lartigau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000528:radiation effects; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D016019:Survival Analysis; D055815:Young Adult