What radiation dose, fractionation and volume would you use in an elderly patient with localized extensive anorectal malignant melanoma status post laparoscopic APR?
Would your recommendation change with the following aggressive features: 8 cm, pericolic extension, positive radial margin, perineural invasion present, 1 of 15 lymph nodes positive with extranodal extention?
Answer from: Radiation Oncologist at Community Practice
What a great question! This has come up a couple of times in my clinical practice. For anorectal mucosal melanoma that is completely excised and < 7 mm depth of invasion, I have done surface intra-cavitary brachytherapy with a Capri cylinder.
For deeper lesions or LN involvement, I have us...
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