Survival Benefit of Stereotactic Radiotherapy in the Complex Management of Metastatic Melanoma.
Anticancer Res
; 44(1): 205-212, 2024 Jan.
Article
en En
| MEDLINE
| ID: mdl-38159978
ABSTRACT
BACKGROUND/AIM:
Targeted therapy and immunotherapy, with additional stereotactic radiation therapy (SRT) have revolutionized the management of metastatic malignant melanoma (mMM). We aimed to analyze the effectiveness and safety of SRT and determine its role in the complex management of mMM. PATIENTS ANDMETHODS:
We treated 24 patients with solitary metastasis, 15 with oligometastatic disease and one with multiple metastases. The primary endpoint was to investigate the possible effect of stereotactic radiotherapy for metastatic lesions on patients' survival taking the systemic therapy into consideration.RESULTS:
The median overall survival (OS) for the entire group was 30.07 months; 50% of them received immunotherapy, 32% received targeted therapy. Complete remission of the irradiated lesions was observed in six patients, partial tumor response was achieved in 13, while stable disease was detected in 10; tumor progression occurred in four cases. Compartmental recurrence (recurrence in the brain in a not previously irradiated region) developed in seven patients. OS was significantly longer in those with extracranial metastases treated with stereotactic body radiotherapy in comparison to brain SRT. We found a strong correlation between tumor response and mean OS (42.5 months after complete or partial remission versus 11.8 months in those with stable or progressive disease). No OS difference was observed according to the number of irradiated lesions or type of systemic therapy before SRT (no therapy 43.6 months, with therapy 25.7 months). Significant OS advantage was shown when immunotherapy was administered post-SRT (mean OS with immunotherapy 39.6 months, no immunotherapy 18.5 months).CONCLUSION:
In the case of oligometastatic MM, SRT can be used safely and with good efficiency in addition to targeted therapy/anti-programmed cell death protein 1 therapy. Improved survival warrants including SRT in the complex management of mMM, however, further studies are needed for SRT optimization.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Encefálicas
/
Radiocirugia
/
Melanoma
Límite:
Humans
Idioma:
En
Año:
2024
Tipo del documento:
Article