Lancet Oncology this week:
The Australian trial of adjuvant RT for nodal basins for melanoma, initially presented in ASTRO several years ago, has finally seen publication - again confirming a local control benefit to 48Gy in 24 fractions. The entry criteria was slightly complex, depending on size and # of nodes that was different per site, with extranodal extension always qualifying. Perhaps not surprisingly, there was no benefit for survival in such a small trial, but it was not powered for this regardless. In light of the relative lack of efficacy of standard chemotherapy, RT still seems to be the most reasonable option of any treatment outside of those with BRAF mutations.
[Articles] Adjuvant radiotherapy versus observation alone for patients at risk of lymph-node field relapse after therapeutic lymphadenectomy for melanoma: a randomised trial: Adjuvant radiotherapy improves lymph-node field control in patients at high risk of lymph-node field relapse after therapeutic lymphadenectomy for metastatic melanoma. Adjuvant radiotherapy should be discussed with patients at high risk of relapse after lymphadenectomy.