title: The use of high dose rate brachytherapy palliation after failed palliative external beam radiotherapy for a cutaneous malignant melanoma of the foot: a case report.
abstract: BACKGROUND
  While surgery is the mainstay of therapy for primary cutaneous melanoma, some very locally advanced lesions are either unresectable or the morbidity of resection is unacceptably high in the setting of metastatic disease. These types of primary melanomas must be addressed with alternative measures including chemotherapy, immunotherapy, radiotherapy, or a combination of the above.
  
  
  METHODS
  We treated a cutaneous lesion palliatively with high dose rate brachytherapy after having minimal tumor response to external beam radiation therapy. The tumor regressed after treatment, but a new lesion subsequently developed in its previous location.
  
  
  RESULTS
  High dose rate brachytherapy may have a substantial impact on the management of cutaneous lesions, but further studies on its efficacy and toxicity must be evaluated.
authors.affiliation: College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA. hobbs.corey@gmail.com
authors.forename: Corey
authors.initials: C
authors.lastname: Hobbs
authors.forename: Jennifer
authors.initials: J
authors.lastname: Harper
mesh_terms: D001918:Brachytherapy / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008545:Melanoma / Q000532:radiotherapy* / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011859:Radiography; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D017211:Treatment Failure