Role of radiation therapy in the treatment of melanoma.

Melanoma has been widely described as radioresistant but this should not be construed as meaning that melanoma is radioincurable. Many melanoma cell lines are as radiosensitive as other tumors commonly treated successfully with radiotherapy (RT). The use of RT requires careful planning resulting in the administration of a tumoricidal dose to the tumor cells with adequate sparing of normal tissues. RT has been used for primary therapy, postresection adjuvant therapy and palliation of symptomatic melanoma. Curative RT has been given for uveal melanoma yielding patient survival equivalent to enucleation. RT has been administered to patients with unresectable disease yielding relatively favorable results. As an adjuvant therapy postoperatively, RT has been used selectively to improve local disease control. Finally, RT is used successfully as a palliative maneuver for symptoms related to distant metastatic melanoma in patients with incurable disease.