title: Melanoma: Last call for radiotherapy.
abstract: Melanoma is traditionally considered to be a radioresistant tumor. However, radiotherapy and immunotherapy latest developments might upset this radiobiological dogma. Stereotactic radiotherapy allows high dose per fraction delivery, with high dose rate. More DNA lethal damages, less sublethal damages reparation, endothelial cell apoptosis, and finally clonogenic cell dysfunction are produced, resulting in improved local control. Radiotherapy can also enhance immune responses, inducing neoantigens formation, tumor antigen presentation, and cytokines release. A synergic effect of radiotherapy with immunotherapy is expected, and might lead to abscopal effects. If hadrontherapy biological properties seem able to suppress hypoxia-induced radioresistance and increase biological efficacy, ballistic advantages over photon radiations might also improve radiotherapy outcomes on usually poor prognosis locations. The present review addresses biological and clinical effects of high fraction dose, bystander effect, abscopal effect, and hadrontherapy features in melanoma. Clinical trials results are warranted to establish indications of innovative radiotherapy in melanoma.
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Espenel
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Vallard
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France. Electronic address: chloerancoule@gmail.com.
authors.forename: Chloé
authors.initials: C
authors.lastname: Rancoule
authors.affiliation: Public Health Department, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France.
authors.forename: Max-Adrien
authors.initials: MA
authors.lastname: Garcia
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Radiotherapy, Gustave Roussy Institute, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Radiotherapy, Gustave Roussy Institute, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Deutsch
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France; Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 108 bis avenue Albert Raimond, BP60008, 42271 Saint Priest en Jarez cedex, France. Electronic address: nicolas.magne@icloire.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
mesh_terms: D024201:Bystander Effect; D006801:Humans; D007167:Immunotherapy; D008545:Melanoma / Q000188:drug therapy / Q000276:immunology / Q000532:radiotherapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D011829:Radiation Dosage
chemical_list: D047428:Protein Kinase Inhibitors; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: Dose hypofractionation; Heavy ion radiotherapy; Melanoma; Radioimmunotherapy; Radiotherapy