Radiology, Vol 164, 607-610, Copyright © 1987 by Radiological Society of North America
Malignant melanoma: analysis of dose fractionation in radiation therapy
JB Konefal, B Emami and MV Pilepich
Thirty-five patients with 67 measureable cutaneous or lymph node metastases
from malignant melanoma were treated with radiation therapy in a variety of
total doses and dose fractions. There was no correlation between total dose
and response rate. However, there was a strong correlation between fraction
size and response rate. There were four (9%) complete responses in 43
lesions treated with fractions less than or equal to 500 rad (5 Gy)
compared with 12 (50%) complete responses in 24 lesions treated with
fractions greater than 500 rad (5 Gy) (P = .0006). Initial response rate
was found to correlate strongly with local control at 1 year. The results
were then analyzed with respect to lesion size, cutaneous versus nodal
lesions, and site of cutaneous lesion (trunk, head and neck, or extremity).
Correlation between fraction size and response rate was independent of
lesion size, although there were fewer complete responses with increasing
lesion size. Correlation was not seen in nodal lesions but was particularly
striking in cutaneous lesions. This correlation was statistically
significant only for cutaneous lesions of the extremities.
