RT Book, Section A1 Hong, Angela M. A1 Fogarty, Gerald B. A2 Morita, Shane Y. A2 Balch, Charles M. A2 Klimberg, V. Suzanne A2 Pawlik, Timothy M. A2 Posner, Mitchell C. A2 Tanabe, Kenneth K. SR Print(0) ID 1145756081 T1 Radiation Therapy for Metastatic Melanoma T2 Textbook of Complex General Surgical Oncology YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9780071793315 LK hemonc.mhmedical.com/content.aspx?aid=1145756081 RD 2024/03/28 AB Radiation therapy (RT) in patients with metastatic melanoma in regional lymph nodes may be used as adjuvant treatment, or occasionally as definitive treatment, when surgery is not feasible or contraindicated. The rationale for adjuvant RT in patients with stage III melanoma is to reduce the risk of regional node field recurrence, which can cause significant morbidity and seriously reduce quality of life. The notion that melanoma rarely responds to RT has been dispelled by a recent randomized study in patients with AJCC stage III melanoma that demonstrated a significant reduction in node field recurrence with the addition of adjuvant RT.1 Whether improved regional control improves survival remains speculative. However, metastasis to a regional node field undoubtedly indicates an increased risk of distant metastasis, with a progressive reduction in survival associated with increasing tumor burden in the node field.2