Elective Radiotherapy Provides Regional Control for Patients with Cutaneous Melanoma of the Head and Neck

Mark D. Bonnen, Matthew Ballo, Jeffrey N. Myers, Adam S. Garden, Eduardo M. Diaz, Jeffrey E. Gershenwald, William H. Morrison, Jeffrey E. Lee, Mary Jane Oswald, Merrick I. Ross, K. Kian Ang

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55 Citations (Scopus)

Abstract

BACKGROUND. In the current study, the authors assessed the efficacy of elective radiotherapy in providing regional (lymph node) control in patients with cutaneous melanoma of the head and neck who were at high risk for lymph node involvement. Toxicity was also assessed. METHODS. From 1983 to 1998, 157 patients with Stage I or II cutaneous melanoma of the head and neck received elective regional radiotherapy after wide local excision of the primary lesion. None of the patients had received sentinel lymph node biopsy or dissection of the lymph nodes. Their medical records were reviewed retrospectively and analyzed for outcome. RESULTS. The median follow-up for the current review was 68 months (range, 7-185 months). The disease recurred locally in 9 patients, in the neck lymph nodes in 15 patients, and distantly in 57 patients. The actuarial regional control rate was 89% at both 5 years and 10 years. The actuarial disease-specific survival and distant metastasis-free survival rates were 68% and 63%, respectively, at 5 years and 58% and 49%, respectively, at 10 years. Breslow thickness was a significant determinant of disease-specific survival and distant metastasis-free survival rates. At 10 years, 6% of patients had developed a symptomatic treatment-related complication. There were no treatment-related deaths. CONCLUSIONS. The results of the current study confirmed the efficacy and safety of elective regional radiotherapy for patients with cutaneous head and neck melanoma predicted to have a high rate of lymph node involvement. Elective irradiation was a viable alternative to elective lymph node dissection. It may also serve as an alternative to sentinel lymph node biopsy, particularly for patients for whom dissection and systemic therapy are not therapeutic options.

Original languageEnglish (US)
Pages (from-to)383-389
Number of pages7
JournalCancer
Volume100
Issue number2
DOIs
StatePublished - Jan 15 2004

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Melanoma
Neck
Radiotherapy
Head
Skin
Lymph Nodes
Sentinel Lymph Node Biopsy
Lymph Node Excision
Survival Rate
Neoplasm Metastasis
Survival
Therapeutics
Medical Records
Dissection
Safety

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Bonnen, M. D., Ballo, M., Myers, J. N., Garden, A. S., Diaz, E. M., Gershenwald, J. E., ... Ang, K. K. (2004). Elective Radiotherapy Provides Regional Control for Patients with Cutaneous Melanoma of the Head and Neck. Cancer, 100(2), 383-389. https://doi.org/10.1002/cncr.11921

Elective Radiotherapy Provides Regional Control for Patients with Cutaneous Melanoma of the Head and Neck. / Bonnen, Mark D.; Ballo, Matthew; Myers, Jeffrey N.; Garden, Adam S.; Diaz, Eduardo M.; Gershenwald, Jeffrey E.; Morrison, William H.; Lee, Jeffrey E.; Oswald, Mary Jane; Ross, Merrick I.; Ang, K. Kian.

In: Cancer, Vol. 100, No. 2, 15.01.2004, p. 383-389.

Research output: Contribution to journalArticle

Bonnen, MD, Ballo, M, Myers, JN, Garden, AS, Diaz, EM, Gershenwald, JE, Morrison, WH, Lee, JE, Oswald, MJ, Ross, MI & Ang, KK 2004, 'Elective Radiotherapy Provides Regional Control for Patients with Cutaneous Melanoma of the Head and Neck', Cancer, vol. 100, no. 2, pp. 383-389. https://doi.org/10.1002/cncr.11921
Bonnen, Mark D. ; Ballo, Matthew ; Myers, Jeffrey N. ; Garden, Adam S. ; Diaz, Eduardo M. ; Gershenwald, Jeffrey E. ; Morrison, William H. ; Lee, Jeffrey E. ; Oswald, Mary Jane ; Ross, Merrick I. ; Ang, K. Kian. / Elective Radiotherapy Provides Regional Control for Patients with Cutaneous Melanoma of the Head and Neck. In: Cancer. 2004 ; Vol. 100, No. 2. pp. 383-389.
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abstract = "BACKGROUND. In the current study, the authors assessed the efficacy of elective radiotherapy in providing regional (lymph node) control in patients with cutaneous melanoma of the head and neck who were at high risk for lymph node involvement. Toxicity was also assessed. METHODS. From 1983 to 1998, 157 patients with Stage I or II cutaneous melanoma of the head and neck received elective regional radiotherapy after wide local excision of the primary lesion. None of the patients had received sentinel lymph node biopsy or dissection of the lymph nodes. Their medical records were reviewed retrospectively and analyzed for outcome. RESULTS. The median follow-up for the current review was 68 months (range, 7-185 months). The disease recurred locally in 9 patients, in the neck lymph nodes in 15 patients, and distantly in 57 patients. The actuarial regional control rate was 89{\%} at both 5 years and 10 years. The actuarial disease-specific survival and distant metastasis-free survival rates were 68{\%} and 63{\%}, respectively, at 5 years and 58{\%} and 49{\%}, respectively, at 10 years. Breslow thickness was a significant determinant of disease-specific survival and distant metastasis-free survival rates. At 10 years, 6{\%} of patients had developed a symptomatic treatment-related complication. There were no treatment-related deaths. CONCLUSIONS. The results of the current study confirmed the efficacy and safety of elective regional radiotherapy for patients with cutaneous head and neck melanoma predicted to have a high rate of lymph node involvement. Elective irradiation was a viable alternative to elective lymph node dissection. It may also serve as an alternative to sentinel lymph node biopsy, particularly for patients for whom dissection and systemic therapy are not therapeutic options.",
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AU - Bonnen, Mark D.

AU - Ballo, Matthew

AU - Myers, Jeffrey N.

AU - Garden, Adam S.

AU - Diaz, Eduardo M.

AU - Gershenwald, Jeffrey E.

AU - Morrison, William H.

AU - Lee, Jeffrey E.

AU - Oswald, Mary Jane

AU - Ross, Merrick I.

AU - Ang, K. Kian

PY - 2004/1/15

Y1 - 2004/1/15

N2 - BACKGROUND. In the current study, the authors assessed the efficacy of elective radiotherapy in providing regional (lymph node) control in patients with cutaneous melanoma of the head and neck who were at high risk for lymph node involvement. Toxicity was also assessed. METHODS. From 1983 to 1998, 157 patients with Stage I or II cutaneous melanoma of the head and neck received elective regional radiotherapy after wide local excision of the primary lesion. None of the patients had received sentinel lymph node biopsy or dissection of the lymph nodes. Their medical records were reviewed retrospectively and analyzed for outcome. RESULTS. The median follow-up for the current review was 68 months (range, 7-185 months). The disease recurred locally in 9 patients, in the neck lymph nodes in 15 patients, and distantly in 57 patients. The actuarial regional control rate was 89% at both 5 years and 10 years. The actuarial disease-specific survival and distant metastasis-free survival rates were 68% and 63%, respectively, at 5 years and 58% and 49%, respectively, at 10 years. Breslow thickness was a significant determinant of disease-specific survival and distant metastasis-free survival rates. At 10 years, 6% of patients had developed a symptomatic treatment-related complication. There were no treatment-related deaths. CONCLUSIONS. The results of the current study confirmed the efficacy and safety of elective regional radiotherapy for patients with cutaneous head and neck melanoma predicted to have a high rate of lymph node involvement. Elective irradiation was a viable alternative to elective lymph node dissection. It may also serve as an alternative to sentinel lymph node biopsy, particularly for patients for whom dissection and systemic therapy are not therapeutic options.

AB - BACKGROUND. In the current study, the authors assessed the efficacy of elective radiotherapy in providing regional (lymph node) control in patients with cutaneous melanoma of the head and neck who were at high risk for lymph node involvement. Toxicity was also assessed. METHODS. From 1983 to 1998, 157 patients with Stage I or II cutaneous melanoma of the head and neck received elective regional radiotherapy after wide local excision of the primary lesion. None of the patients had received sentinel lymph node biopsy or dissection of the lymph nodes. Their medical records were reviewed retrospectively and analyzed for outcome. RESULTS. The median follow-up for the current review was 68 months (range, 7-185 months). The disease recurred locally in 9 patients, in the neck lymph nodes in 15 patients, and distantly in 57 patients. The actuarial regional control rate was 89% at both 5 years and 10 years. The actuarial disease-specific survival and distant metastasis-free survival rates were 68% and 63%, respectively, at 5 years and 58% and 49%, respectively, at 10 years. Breslow thickness was a significant determinant of disease-specific survival and distant metastasis-free survival rates. At 10 years, 6% of patients had developed a symptomatic treatment-related complication. There were no treatment-related deaths. CONCLUSIONS. The results of the current study confirmed the efficacy and safety of elective regional radiotherapy for patients with cutaneous head and neck melanoma predicted to have a high rate of lymph node involvement. Elective irradiation was a viable alternative to elective lymph node dissection. It may also serve as an alternative to sentinel lymph node biopsy, particularly for patients for whom dissection and systemic therapy are not therapeutic options.

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