Nodal radiation therapy for metastatic melanoma
Identifieur interne : 000C07 ( Istex/Corpus ); précédent : 000C06; suivant : 000C08Nodal radiation therapy for metastatic melanoma
Auteurs : June Corry ; Jennifer G. Smith ; Michelle Bishop ; Jill AinslieSource :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 1999.
English descriptors
Abstract
Purpose: The aim of this retrospective study was to review our experience of radiation therapy to regional nodes in patients with proven nodal metastases, with respect to regional control, late toxicity, and overall survival. Methods and Materials: All patients with a histological diagnosis of malignant melanoma, with involvement of the regional nodes but without distant metastases, who commenced nodal irradiation between January 1985 and July 1995 at Peter MacCallum Cancer Institute were studied. The study population of 113 patients was divided into two categories: those with no residual macroscopic disease following nodal surgery (adjuvant group, 42 patients) and those who had no surgery (8) or had macroscopic residual disease following nodal surgery (63) (palliative group, 71 patients). Results: In the adjuvant group at 5 years following commencement of nodal irradiation 26% were estimated to be failure-free. Of the 74% who had experienced treatment failure by 5 years, an estimated 20% failed first with nodal relapse, 52% with distant metastases, and 2% with both nodal relapse and distant metastases. The estimated 5-year overall survival for this group was 33%. In the palliative group 16 patients (23%) had an objective complete response. Altogether 48 patients (68%) had a symptomatic response. At 5 years the overall survival in this group was 8% and an estimated 4% were failure-free. Of the 96% who had failed by 5 years, 68% failed first in the regional nodes, 25% had distant metastases as the first failure, and 3% had both nodal relapse and distant metastases. Conclusion: We recommend adjuvant postoperative radiation therapy for patients with proven nodal metastases and high risk of regional recurrence (multiple nodes, extracapsular extension, or recurrent nodal disease) in addition to adjuvant interferon.
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DOI: 10.1016/S0360-3016(99)00131-5
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ISTEX:19D8A3C49A4E2E798CF358F9826E7928A4077B69Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Nodal radiation therapy for metastatic melanoma</title><author><name sortKey="Corry, June" sort="Corry, June" uniqKey="Corry J" first="June" last="Corry">June Corry</name><affiliation><mods:affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Smith, Jennifer G" sort="Smith, Jennifer G" uniqKey="Smith J" first="Jennifer G" last="Smith">Jennifer G. Smith</name><affiliation><mods:affiliation>Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Bishop, Michelle" sort="Bishop, Michelle" uniqKey="Bishop M" first="Michelle" last="Bishop">Michelle Bishop</name><affiliation><mods:affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Ainslie, Jill" sort="Ainslie, Jill" uniqKey="Ainslie J" first="Jill" last="Ainslie">Jill Ainslie</name><affiliation><mods:affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:19D8A3C49A4E2E798CF358F9826E7928A4077B69</idno><date when="1999" year="1999">1999</date><idno type="doi">10.1016/S0360-3016(99)00131-5</idno><idno type="url">https://api.istex.fr/document/19D8A3C49A4E2E798CF358F9826E7928A4077B69/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000C07</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000C07</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Nodal radiation therapy for metastatic melanoma</title><author><name sortKey="Corry, June" sort="Corry, June" uniqKey="Corry J" first="June" last="Corry">June Corry</name><affiliation><mods:affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Smith, Jennifer G" sort="Smith, Jennifer G" uniqKey="Smith J" first="Jennifer G" last="Smith">Jennifer G. Smith</name><affiliation><mods:affiliation>Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Bishop, Michelle" sort="Bishop, Michelle" uniqKey="Bishop M" first="Michelle" last="Bishop">Michelle Bishop</name><affiliation><mods:affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author><author><name sortKey="Ainslie, Jill" sort="Ainslie, Jill" uniqKey="Ainslie J" first="Jill" last="Ainslie">Jill Ainslie</name><affiliation><mods:affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="ISSN">0360-3016</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">44</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1065">1065</biblScope><biblScope unit="page" to="1069">1069</biblScope></imprint><idno type="ISSN">0360-3016</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Malignant melanoma</term><term>Nodal metastases</term><term>Radiation therapy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: The aim of this retrospective study was to review our experience of radiation therapy to regional nodes in patients with proven nodal metastases, with respect to regional control, late toxicity, and overall survival. Methods and Materials: All patients with a histological diagnosis of malignant melanoma, with involvement of the regional nodes but without distant metastases, who commenced nodal irradiation between January 1985 and July 1995 at Peter MacCallum Cancer Institute were studied. The study population of 113 patients was divided into two categories: those with no residual macroscopic disease following nodal surgery (adjuvant group, 42 patients) and those who had no surgery (8) or had macroscopic residual disease following nodal surgery (63) (palliative group, 71 patients). Results: In the adjuvant group at 5 years following commencement of nodal irradiation 26% were estimated to be failure-free. Of the 74% who had experienced treatment failure by 5 years, an estimated 20% failed first with nodal relapse, 52% with distant metastases, and 2% with both nodal relapse and distant metastases. The estimated 5-year overall survival for this group was 33%. In the palliative group 16 patients (23%) had an objective complete response. Altogether 48 patients (68%) had a symptomatic response. At 5 years the overall survival in this group was 8% and an estimated 4% were failure-free. Of the 96% who had failed by 5 years, 68% failed first in the regional nodes, 25% had distant metastases as the first failure, and 3% had both nodal relapse and distant metastases. Conclusion: We recommend adjuvant postoperative radiation therapy for patients with proven nodal metastases and high risk of regional recurrence (multiple nodes, extracapsular extension, or recurrent nodal disease) in addition to adjuvant interferon.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>nodal</json:string><json:string>metastasis</json:string><json:string>node</json:string><json:string>melanoma</json:string><json:string>adjuvant</json:string><json:string>radiation therapy</json:string><json:string>distant metastases</json:string><json:string>relapse</json:string><json:string>extracapsular</json:string><json:string>palliative group</json:string><json:string>adjuvant group</json:string><json:string>photon</json:string><json:string>metastatic</json:string><json:string>overall survival</json:string><json:string>palliative</json:string><json:string>malignant</json:string><json:string>malignant melanoma</json:string><json:string>eld</json:string><json:string>nodal relapse</json:string><json:string>toxicity</json:string><json:string>nodal surgery</json:string><json:string>median</json:string><json:string>late toxicity</json:string><json:string>regional nodes</json:string><json:string>recurrent nodal disease</json:string><json:string>nodal metastases</json:string><json:string>multiple nodes</json:string><json:string>regional control</json:string><json:string>nodal irradiation</json:string><json:string>unrelated causes</json:string><json:string>adjuvant interferon</json:string><json:string>extracapsular extension</json:string><json:string>cumulative incidence</json:string><json:string>maccallum cancer institute</json:string><json:string>nodal disease</json:string><json:string>median time</json:string><json:string>prognostic factors</json:string><json:string>anterior photon</json:string><json:string>treatment failure</json:string><json:string>study population</json:string><json:string>simultaneous nodal relapse</json:string><json:string>arch surg</json:string></teeft></keywords><author><json:item><name>June Corry</name><affiliations><json:string>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</json:string></affiliations></json:item><json:item><name>Jennifer G Smith Ph.D.</name><affiliations><json:string>Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</json:string></affiliations></json:item><json:item><name>Michelle Bishop</name><affiliations><json:string>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</json:string></affiliations></json:item><json:item><name>Jill Ainslie</name><affiliations><json:string>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Melanoma</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Malignant melanoma</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Nodal metastases</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiation therapy</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Purpose: The aim of this retrospective study was to review our experience of radiation therapy to regional nodes in patients with proven nodal metastases, with respect to regional control, late toxicity, and overall survival. Methods and Materials: All patients with a histological diagnosis of malignant melanoma, with involvement of the regional nodes but without distant metastases, who commenced nodal irradiation between January 1985 and July 1995 at Peter MacCallum Cancer Institute were studied. The study population of 113 patients was divided into two categories: those with no residual macroscopic disease following nodal surgery (adjuvant group, 42 patients) and those who had no surgery (8) or had macroscopic residual disease following nodal surgery (63) (palliative group, 71 patients). Results: In the adjuvant group at 5 years following commencement of nodal irradiation 26% were estimated to be failure-free. Of the 74% who had experienced treatment failure by 5 years, an estimated 20% failed first with nodal relapse, 52% with distant metastases, and 2% with both nodal relapse and distant metastases. The estimated 5-year overall survival for this group was 33%. In the palliative group 16 patients (23%) had an objective complete response. Altogether 48 patients (68%) had a symptomatic response. At 5 years the overall survival in this group was 8% and an estimated 4% were failure-free. Of the 96% who had failed by 5 years, 68% failed first in the regional nodes, 25% had distant metastases as the first failure, and 3% had both nodal relapse and distant metastases. Conclusion: We recommend adjuvant postoperative radiation therapy for patients with proven nodal metastases and high risk of regional recurrence (multiple nodes, extracapsular extension, or recurrent nodal disease) in addition to adjuvant interferon.</abstract><qualityIndicators><score>5.66</score><pdfVersion>1.2</pdfVersion><pdfPageSize>586 x 785 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1841</abstractCharCount><pdfWordCount>2660</pdfWordCount><pdfCharCount>17035</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>280</abstractWordCount></qualityIndicators><title>Nodal radiation therapy for metastatic melanoma</title><pii><json:string>S0360-3016(99)00131-5</json:string></pii><genre><json:string>research-article</json:string></genre><host><title>International Journal of Radiation Oncology, Biology, Physics</title><language><json:string>unknown</json:string></language><publicationDate>1999</publicationDate><issn><json:string>0360-3016</json:string></issn><pii><json:string>S0360-3016(00)X0062-4</json:string></pii><volume>44</volume><issue>5</issue><pages><first>1065</first><last>1069</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>radiology, nuclear medicine & medical imaging</json:string><json:string>oncology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>1999</publicationDate><copyrightDate>1999</copyrightDate><doi><json:string>10.1016/S0360-3016(99)00131-5</json:string></doi><id>19D8A3C49A4E2E798CF358F9826E7928A4077B69</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/19D8A3C49A4E2E798CF358F9826E7928A4077B69/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/19D8A3C49A4E2E798CF358F9826E7928A4077B69/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/19D8A3C49A4E2E798CF358F9826E7928A4077B69/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Nodal radiation therapy for metastatic melanoma</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©1999 Elsevier Science Inc.</p></availability><date>1999</date></publicationStmt><notesStmt><note type="content">Section title: Clinical Investigations</note><note type="content">Fig. 1: Time to failure from commencement of radiation therapy. Vertical marks indicate censoring for patients who were still failure-free by the close-out date or who had died of unrelated causes without failure.</note><note type="content">Fig. 2: Cumulative incidence of sites of first failure for adjuvant patients.</note><note type="content">Fig. 3: Overall survival from commencement of radiation therapy. Vertical marks indicate censoring of patients who were still alive at the close-out date.</note><note type="content">Table 1: Patient and tumor characteristics</note><note type="content">Table 2: Preradiation therapy staging investigations</note><note type="content">Table 3: Prognostic factors, adjuvant group</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Nodal radiation therapy for metastatic melanoma</title><author xml:id="author-0000"><persName><forename type="first">June</forename><surname>Corry</surname></persName><note type="biography">F.R.A.C.P., F.R.A.C.R.</note><note type="biography">Reprint requests to: Dr. J. Corry, Division of Radiation Oncology, Peter MacCallum Cancer Institute, St Andrews Place, East Melbourne, Victoria 3002, Australia</note><affiliation>F.R.A.C.P., F.R.A.C.R.</affiliation><affiliation>Reprint requests to: Dr. J. Corry, Division of Radiation Oncology, Peter MacCallum Cancer Institute, St Andrews Place, East Melbourne, Victoria 3002, Australia</affiliation><affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Jennifer G</forename><surname>Smith</surname></persName><roleName type="degree">Ph.D.</roleName><affiliation>Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Michelle</forename><surname>Bishop</surname></persName><note type="biography">F.R.A.C.R.</note><affiliation>F.R.A.C.R.</affiliation><affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Jill</forename><surname>Ainslie</surname></persName><note type="biography">F.R.A.C.R.</note><affiliation>F.R.A.C.R.</affiliation><affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation></author><idno type="istex">19D8A3C49A4E2E798CF358F9826E7928A4077B69</idno><idno type="DOI">10.1016/S0360-3016(99)00131-5</idno><idno type="PII">S0360-3016(99)00131-5</idno></analytic><monogr><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="pISSN">0360-3016</idno><idno type="PII">S0360-3016(00)X0062-4</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999"></date><biblScope unit="volume">44</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1065">1065</biblScope><biblScope unit="page" to="1069">1069</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1999</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Purpose: The aim of this retrospective study was to review our experience of radiation therapy to regional nodes in patients with proven nodal metastases, with respect to regional control, late toxicity, and overall survival. Methods and Materials: All patients with a histological diagnosis of malignant melanoma, with involvement of the regional nodes but without distant metastases, who commenced nodal irradiation between January 1985 and July 1995 at Peter MacCallum Cancer Institute were studied. The study population of 113 patients was divided into two categories: those with no residual macroscopic disease following nodal surgery (adjuvant group, 42 patients) and those who had no surgery (8) or had macroscopic residual disease following nodal surgery (63) (palliative group, 71 patients). Results: In the adjuvant group at 5 years following commencement of nodal irradiation 26% were estimated to be failure-free. Of the 74% who had experienced treatment failure by 5 years, an estimated 20% failed first with nodal relapse, 52% with distant metastases, and 2% with both nodal relapse and distant metastases. The estimated 5-year overall survival for this group was 33%. In the palliative group 16 patients (23%) had an objective complete response. Altogether 48 patients (68%) had a symptomatic response. At 5 years the overall survival in this group was 8% and an estimated 4% were failure-free. Of the 96% who had failed by 5 years, 68% failed first in the regional nodes, 25% had distant metastases as the first failure, and 3% had both nodal relapse and distant metastases. Conclusion: We recommend adjuvant postoperative radiation therapy for patients with proven nodal metastases and high risk of regional recurrence (multiple nodes, extracapsular extension, or recurrent nodal disease) in addition to adjuvant interferon.</p></abstract><textClass><keywords scheme="keyword"><list><head>article-category</head><item><term>Melanoma</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Malignant melanoma</term></item><item><term>Nodal metastases</term></item><item><term>Radiation therapy</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1999">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/19D8A3C49A4E2E798CF358F9826E7928A4077B69/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: ce:floats; body; tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="GR1"></istex:entity><istex:entity SYSTEM="gr2" NDATA="IMAGE" name="GR2"></istex:entity><istex:entity SYSTEM="gr3" NDATA="IMAGE" name="GR3"></istex:entity></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>ROB</jid><aid>6458</aid><ce:pii>S0360-3016(99)00131-5</ce:pii><ce:doi>10.1016/S0360-3016(99)00131-5</ce:doi><ce:copyright type="full-transfer" year="1999">Elsevier Science Inc.</ce:copyright><ce:doctopics><ce:doctopic><ce:text>Melanoma</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:dochead><ce:textfn>Clinical Investigations</ce:textfn></ce:dochead><ce:title>Nodal radiation therapy for metastatic melanoma</ce:title><ce:author-group><ce:author><ce:given-name>June</ce:given-name><ce:surname>Corry</ce:surname><ce:roles>F.R.A.C.P., F.R.A.C.R.</ce:roles><ce:cross-ref refid="AFF1">∗</ce:cross-ref><ce:cross-ref refid="CORR1">*</ce:cross-ref></ce:author><ce:author><ce:given-name>Jennifer G</ce:given-name><ce:surname>Smith</ce:surname><ce:degrees>Ph.D.</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>†</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Michelle</ce:given-name><ce:surname>Bishop</ce:surname><ce:roles>F.R.A.C.R.</ce:roles><ce:cross-ref refid="AFF1">∗</ce:cross-ref></ce:author><ce:author><ce:given-name>Jill</ce:given-name><ce:surname>Ainslie</ce:surname><ce:roles>F.R.A.C.R.</ce:roles><ce:cross-ref refid="AFF1">∗</ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>∗</ce:label><ce:textfn>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>†</ce:label><ce:textfn>Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</ce:textfn></ce:affiliation><ce:correspondence id="CORR1"><ce:label>*</ce:label><ce:text>Reprint requests to: Dr. J. Corry, Division of Radiation Oncology, Peter MacCallum Cancer Institute, St Andrews Place, East Melbourne, Victoria 3002, Australia</ce:text></ce:correspondence></ce:author-group><ce:date-accepted day="22" month="3" year="1999"></ce:date-accepted><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Purpose: The aim of this retrospective study was to review our experience of radiation therapy to regional nodes in patients with proven nodal metastases, with respect to regional control, late toxicity, and overall survival.</ce:simple-para><ce:simple-para>Methods and Materials: All patients with a histological diagnosis of malignant melanoma, with involvement of the regional nodes but without distant metastases, who commenced nodal irradiation between January 1985 and July 1995 at Peter MacCallum Cancer Institute were studied. The study population of 113 patients was divided into two categories: those with no residual macroscopic disease following nodal surgery (adjuvant group, 42 patients) and those who had no surgery (8) or had macroscopic residual disease following nodal surgery (63) (palliative group, 71 patients).</ce:simple-para><ce:simple-para>Results: In the adjuvant group at 5 years following commencement of nodal irradiation 26% were estimated to be failure-free. Of the 74% who had experienced treatment failure by 5 years, an estimated 20% failed first with nodal relapse, 52% with distant metastases, and 2% with both nodal relapse and distant metastases. The estimated 5-year overall survival for this group was 33%. In the palliative group 16 patients (23%) had an objective complete response. Altogether 48 patients (68%) had a symptomatic response. At 5 years the overall survival in this group was 8% and an estimated 4% were failure-free. Of the 96% who had failed by 5 years, 68% failed first in the regional nodes, 25% had distant metastases as the first failure, and 3% had both nodal relapse and distant metastases.</ce:simple-para><ce:simple-para>Conclusion: We recommend adjuvant postoperative radiation therapy for patients with proven nodal metastases and high risk of regional recurrence (multiple nodes, extracapsular extension, or recurrent nodal disease) in addition to adjuvant interferon.</ce:simple-para></ce:abstract-sec></ce:abstract><ce:keywords class="keyword"><ce:section-title>Keywords</ce:section-title><ce:keyword><ce:text>Malignant melanoma</ce:text></ce:keyword><ce:keyword><ce:text>Nodal metastases</ce:text></ce:keyword><ce:keyword><ce:text>Radiation therapy</ce:text></ce:keyword></ce:keywords></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Nodal radiation therapy for metastatic melanoma</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Nodal radiation therapy for metastatic melanoma</title></titleInfo><name type="personal"><namePart type="given">June</namePart><namePart type="family">Corry</namePart><description>F.R.A.C.P., F.R.A.C.R.</description><affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation><description>Reprint requests to: Dr. J. Corry, Division of Radiation Oncology, Peter MacCallum Cancer Institute, St Andrews Place, East Melbourne, Victoria 3002, Australia</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jennifer G</namePart><namePart type="family">Smith</namePart><namePart type="termsOfAddress">Ph.D.</namePart><affiliation>Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michelle</namePart><namePart type="family">Bishop</namePart><description>F.R.A.C.R.</description><affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jill</namePart><namePart type="family">Ainslie</namePart><description>F.R.A.C.R.</description><affiliation>Division of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1999</dateIssued><copyrightDate encoding="w3cdtf">1999</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Purpose: The aim of this retrospective study was to review our experience of radiation therapy to regional nodes in patients with proven nodal metastases, with respect to regional control, late toxicity, and overall survival. Methods and Materials: All patients with a histological diagnosis of malignant melanoma, with involvement of the regional nodes but without distant metastases, who commenced nodal irradiation between January 1985 and July 1995 at Peter MacCallum Cancer Institute were studied. The study population of 113 patients was divided into two categories: those with no residual macroscopic disease following nodal surgery (adjuvant group, 42 patients) and those who had no surgery (8) or had macroscopic residual disease following nodal surgery (63) (palliative group, 71 patients). Results: In the adjuvant group at 5 years following commencement of nodal irradiation 26% were estimated to be failure-free. Of the 74% who had experienced treatment failure by 5 years, an estimated 20% failed first with nodal relapse, 52% with distant metastases, and 2% with both nodal relapse and distant metastases. The estimated 5-year overall survival for this group was 33%. In the palliative group 16 patients (23%) had an objective complete response. Altogether 48 patients (68%) had a symptomatic response. At 5 years the overall survival in this group was 8% and an estimated 4% were failure-free. Of the 96% who had failed by 5 years, 68% failed first in the regional nodes, 25% had distant metastases as the first failure, and 3% had both nodal relapse and distant metastases. Conclusion: We recommend adjuvant postoperative radiation therapy for patients with proven nodal metastases and high risk of regional recurrence (multiple nodes, extracapsular extension, or recurrent nodal disease) in addition to adjuvant interferon.</abstract><note type="content">Section title: Clinical Investigations</note><note type="content">Fig. 1: Time to failure from commencement of radiation therapy. Vertical marks indicate censoring for patients who were still failure-free by the close-out date or who had died of unrelated causes without failure.</note><note type="content">Fig. 2: Cumulative incidence of sites of first failure for adjuvant patients.</note><note type="content">Fig. 3: Overall survival from commencement of radiation therapy. Vertical marks indicate censoring of patients who were still alive at the close-out date.</note><note type="content">Table 1: Patient and tumor characteristics</note><note type="content">Table 2: Preradiation therapy staging investigations</note><note type="content">Table 3: Prognostic factors, adjuvant group</note><subject><genre>article-category</genre><topic>Melanoma</topic></subject><subject lang="en"><genre>Keywords</genre><topic>Malignant melanoma</topic><topic>Nodal metastases</topic><topic>Radiation therapy</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Radiation Oncology, Biology, Physics</title></titleInfo><titleInfo type="abbreviated"><title>ROB</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19990715</dateIssued></originInfo><identifier type="ISSN">0360-3016</identifier><identifier type="PII">S0360-3016(00)X0062-4</identifier><part><date>19990715</date><detail type="volume"><number>44</number><caption>vol.</caption></detail><detail type="issue"><number>5</number><caption>no.</caption></detail><extent unit="issue pages"><start>975</start><end>1212</end></extent><extent unit="pages"><start>1065</start><end>1069</end></extent></part></relatedItem><identifier type="istex">19D8A3C49A4E2E798CF358F9826E7928A4077B69</identifier><identifier type="DOI">10.1016/S0360-3016(99)00131-5</identifier><identifier type="PII">S0360-3016(99)00131-5</identifier><accessCondition type="use and reproduction" contentType="copyright">©1999 Elsevier Science Inc.</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Elsevier Science Inc., ©1999</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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