Radiotherapy in the Treatment of Subcutaneous Melanoma
Abstract
:Simple Summary
Abstract
1. Introduction
1.1. Radiotherapy Overview
1.2. Radiotherapy and Hyperthermia
1.3. Radiotherapy and Intralesional (IL) Therapies
1.4. Boron Neutron Capture Therapy (BNCT)
1.5. Brachytherapy (BT)
1.6. Radiotherapy and Immunotherapy
1.7. Radiotherapy and Targeted Therapy
2. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Author/Year | No. of Pts/ No. of Lesions Treated | Treatment | HT | RT (Total Dose/Dose Fr/No. of Frs/Days) | Results LC/OS | Factors Affecting Response Rate (Positively) | Toxicity of HT + RT |
---|---|---|---|---|---|---|---|
Overgaard (1995) | 70/134 | RT alone RT + HT | 43 °C for 60 min within 30 min following RT | 24 Gy/8 Gy/3/8 or 27 Gy/9 Gy/3/8 | RT alone CR: 35% LC-2 y: 28% HT + RT CR: 62% LC-2 y: 46% 5-year OS 19% for all pts 38% for pts for whom all known diseases were controlled | Total radiation dose (≥27 Gy) and tumor volume (<4 cm). | No increase in acute/late radiation reactions Pain (6%) |
Gonzalez Gonzalez (1986) | 24/49 | RT alone (8 l) RT + HT (38 l) HT alone (3 l) | 43 °C within 30 min following RT | 24 Gy/8 Gy/3/21 24 Gy/8 Gy/3/14 18 Gy/6 Gy/3/21 18 Gy/6 Gy/3/14 24 Gy/4 Gy/6/21 25 Gy/5 Gy/6/21 1 fr on day 1, 8, 14 or 1, 8, 21 or 2 frs per week in 21 days | HT + RT CR 50% in all pts CR 83% in pts treated with RT 8 Gy per fr RT alone CR 38% HT alone No response | Size of dose per fr (large) and tumor volume (small sizes). | Enhancement of acute skin reaction but not significant |
Kim (1982) | 38/100 | RT alone RT + HT | 30 min at 42.0–43.5 °C immediately prior to RT | 42.90 Gy/3.3 Gy/13/twice per week or 40 Gy/4 Gy/10/ twice per week or 38.5 Gy/5.5 Gy/7/once per week or 39.6 Gy/6.6 Gy/6/once per week | Overall CR rate 75% HT + RT 46% RT alone (p < 0.01) | Frs per week (once per week regimen) and tumor volume (more than 10 cm3) | Not enhanced, normal tissue morbidity |
Engin (1993) | 126 (33 with MM) | RT alone RT + HT | 45 °C (skin <43 °C) for 60 min within 15–30 min after RT | Mean RT dose 45 Gy ± 1 Gy (range, 13–80 Gy)/median dose 40 Gy/dose per fr in the range of 1.6–4.8 Gy/16 frs (range, 5–54 fractions)/35 days (range, 14–94 days) | CR 49% for all lesions 70% for superficial lesions 18% for deep lesions (p < 0.001) CR 36% for superficial deposits of MM OS 16.1 ±1.2 mo for superficial lesions 8.7 ± 1.1 mo for deep lesions (p = 0.00l) | Size of dose per fr (3–4 Gy), tumor volume . (<3 cm), and depth of lesions (superficial) | None (42, 33%) Erythema (59, 47%) Thermal blistering (25, 20%) Ulceration (27) |
Emami (1988) | 18/49 (28 CM or SM) | RT alone RT + HT | 43 °C for 60 min, twice per week (72 h apart), for the duration of RT | Range 20–60 Gy/range 4–8 Gy | Rt alone CR: 23.9% PR: 34.3% RT + HT CR: 59.2% PR: 12.2% | Tumor volume (<3 cm) | - |
Perez (1991) | 307 * | RT alone RT + HT | 43 °C for 60 min | 32 Gy/4 Gy/8 frs/over 4 weeks | RT alone CR: 30% Tumors <3 cm: CR: 40% B CR: 0% T&E CR:38% H&N RT + HT CR: 32% Tumors <3 cm: CR: 62% B CR: 67% T&E CR:50% H&N | Tumor volume (<3 cm) | Thermal blistering (30%) No increase in acute/late radiation reactions |
Author/Year | No. of pts/ No. of Lesions Treated | Treatment | RT (Total Dose/Dose fr/No. of frs/Days) | Results LC/OS | Factors Affecting Response Rate (Positively) | Toxicity |
---|---|---|---|---|---|---|
Foote (2017) | 15/98 | IL PV-10 + RT | 30 Gy/5 Gy/6/2 frs/week over 3 weeks | ORR 86.6% (CR 33.3%+ PR 53.3%) Clinical benefit 93.3% (CR 33.3% +PR 53.3% + SD 6.7%) MSS (from the time of treatment) 12 mo 77% 24 mo 54% 36-mo 40% Median MSS 30.6 mo from the time of PV-10 treatment Median MSS 41.7 mo from the date of the primary melanoma diagnosis MSM 46.7% | Volume of lesions (≤10 mm) | G1-G2: Injection site pain (80%) Injection site swelling (60%) Injection site blistering (20%) Injection site erythema (20%) Injection site ulceration/bleeding (6.7%) Peripheral lymphedema (26.7%) Cellulitis (6.7%) G3: Injection site pain (6.7%) G4-G5: 0% |
Paul (2003) | 20/- | IL IFN-β +RT | 40–50 Gy/1.8 Gy/5 days week | CR 70% PR 30% OS Pts with CR 4–93 mo (average 18 mo) Pts with PR 4–15 mo (average 8 mo) | - | - |
Plesnicar (1982) | 19/- | IL BCG +RT | The total dose and fractionation scheme was planned for each case individually and based on the degree and intensity of inflammatory response at the BCG injection sites. | groups: 1. Numerous and small (5 pts) CR: 100% 2. Multiple and large (9 pts) CR: 100% 3. Single or few, large (5 pts) CR: 0%, PR: 20%, None: 80% | Number and volume of lesions | - |
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Borzillo, V.; Muto, P. Radiotherapy in the Treatment of Subcutaneous Melanoma. Cancers 2021, 13, 5859. https://doi.org/10.3390/cancers13225859
Borzillo V, Muto P. Radiotherapy in the Treatment of Subcutaneous Melanoma. Cancers. 2021; 13(22):5859. https://doi.org/10.3390/cancers13225859
Chicago/Turabian StyleBorzillo, Valentina, and Paolo Muto. 2021. "Radiotherapy in the Treatment of Subcutaneous Melanoma" Cancers 13, no. 22: 5859. https://doi.org/10.3390/cancers13225859