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

Topics: Radiation Oncology • Melanoma/Skin Cancer

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?

Answer from: Radiation Oncologist at Community Practice

I like this 9 Gy x 3 melanoma regimen by Dr. Jens Overgaard from Denmark:https://www.ncbi.nlm.nih.gov/pubmed/4044346It'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...

Comments

Radiation Oncologist at Karmanos Cancer Institute - McLaren Proton Therapy Center
Correction: the renal cell patient dose was 9 Gy x...

Answer from: Radiation Oncologist at Academic Institution

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

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Radiation Oncologist at Mon Health
Thank you, what are your thoughts about 6 Gy x 5, ...

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