Role of postoperative irradiation for patients with bilateral cervical nodal metastases from cutaneous melanoma: a critical assessment

Head Neck. 2010 Jun;32(6):708-13. doi: 10.1002/hed.21238.

Abstract

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.

Conclusion: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Melanoma / mortality
  • Melanoma / radiotherapy*
  • Melanoma / secondary*
  • Melanoma / surgery
  • Middle Aged
  • Postoperative Care
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / radiotherapy*
  • Young Adult