Mednet Logo

What radiation regimen do you use to palliate bulky melanoma metastases involving the oral cavity?

In this case, I have a patient with widely metastatic cutaneous melanoma (BRAF wild type, NRAS mutated) who is progressing through pembrolizumab and is being switched to ipilimumab/nivolumab. He has a bulky masseter lesion making it difficult for him to chew. Would you treat with 300cGyx10 or use an alternate hyofractionated regimen?
2 Answers
Mednet Member
Mednet Member
Radiation Oncology · Karmanos Cancer Institute - McLaren Proton Therapy Center
Answered on

I like this 9 Gy x 3 melanoma regimen by Dr. Jens Overgaard from Denmark:

https://www.ncbi.nlm.nih.gov/pubmed/4044346

It's an oldie from 1985, but uses roughly the same regimen (9.5 Gy x 3) subsequently found to be the trigger of an abscopal response in a patient progressing on ipilimumab, as reported...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Fox Chase Cancer Center
Answered on

I have successfully used 6 Gy x 6 twice a week for metastatic melanoma.

Join for free or sign in to see the full answer