Surgery has been the standard treatment for melanoma metastatic to lymph nodes [1-4]; however, recent data suggest adjuvant radiotherapy reduces regional nodal recurrence [5]. Regional lymph node recurrence rates range from 5% to 20% after adjuvant radiotherapy compared with 20% to 50% after surgery alone [1-4, 6-11]. Radiotherapy is often not administered because of a belief that melanoma is radioresistant [12]. Studies have suggested high-dose-per-fraction radiotherapy may render melanoma radioresponsive [13]. However, this has not been confirmed by prospective clinical trials [14]. The long-term sequelae of high-dose-per-fraction radiotherapy, especially intensity-modulated radiotherapy (IMRT), in patients with melanoma metastatic to axillary or inguinal lymph nodes have not been thoroughly characterized [7, 12, 14]. The aim of this study was to examine the effects of adjuvant radiotherapy on in-field nodal control (NC) of melanoma metastatic to axillary and inguinal lymph nodes and to document treatment-related complications.
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