A prospective phase II study of adjuvant postoperative radiation therapy following nodal surgery in malignant melanoma–Trans Tasman Radiation Oncology Group (TROG) Study 96.06

Burmeister, Bryan; Smithers, B. Mark; Burmeister, Elizabeth; Baumann, Kathryn; Davis, Sally J.; Krawitz, Hedley; Johnson, Carol; Spry, Nigel

doi:10.1016/j.radonc.2006.10.001

Cited by 101 publications

(87 citation statements)

References 19 publications

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“…19 Furthermore, a multiinstitutional Phase II trial of 234 patients utilizing 2.4 Gy per fraction to a dose of 48 Gy following nodal surgery reported results similar to the other hypofractionation trials. 20 …”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of the role of adjuvant radiotherapy in the treatment of cutaneous melanoma

Baker

Camacho

Andrews

et al. 2016

Cancer Biology & Therapy

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Melanoma is a significant clinical problem, with rising rates of incidence. Surgery is the mainstay of treatment. The role of adjuvant radiotherapy in the control of locoregionally advanced cutaneous melanoma is controversial. A retrospective study of the Surveillance, Epidemiology, and End Results (SEER) database was performed. Patients with locoregionally confined cutaneous melanoma treated surgically between 2004 and 2009 were evaluated, with cancer-specific and all-cause mortality as primary end points. Propensity score matching was used to match 319 radiotherapy patients with 319 nonradiotherapy controls, stratifying by head and neck (HN) and non-head and neck (NHN) primary. Surgery was primarily by wide excision in both the radiotherapy (51.72%) and non-radiotherapy (53.91%) groups. The majority had nodal disease (82.13% vs. 82.44%). White (91.22% vs. 90.59%) males (70.21% vs. 68.96%) predominated. Average ages at diagnosis were 62.27 (SD 15.93) and 63.02 (SD 16.03). Using Cox proportional hazards models, radiation conferred decreased survival in all-cause (HR 1.44, p < 0.0003), and cancer specific mortality (HR 1.57, p < 0.0002) in combined analysis. The NHN group showed significantly decreased 6-year cancer specific survival (HR 2.05, p < 0.0001) for radiated patients. The HN group showed a non-significant hazard with radiotherapy (HR 1.19, p D 0.307). Meaningful differences not captured in the SEER database may exist between cohorts. Based on available SEER data, routine use of adjuvant radiotherapy should be viewed with caution and reserved for high-risk patients. Future trials evaluating patient quality of life may clarify the benefit of adjuvant radiotherapy in high-risk melanoma populations.

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Section: Discussionmentioning

confidence: 99%

A retrospective analysis of the role of adjuvant radiotherapy in the treatment of cutaneous melanoma

Baker

Camacho

Andrews

et al. 2016

Cancer Biology & Therapy

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“…A total of 12 randomized trials investigating preoperative CRT compared to surgery alone were identified (Table 2). 11,[25][26][27][28][29][30][31][32][33][34][35][36] Among the 12 randomized trials, preoperative CRT improves the OS rate of patients with esophageal cancer in only five trials. 11,29,30,33,35 Despite some studies not showing the survival benefit, the advantages of preoperative CRT could be illustrated in certain aspects, such as improved local control rate 25,29 and better complete resection rate.…”

Section: Multimodal Therapy For Esophageal Cancermentioning

confidence: 99%

“…11,29,30,33,35 Despite some studies not showing the survival benefit, the advantages of preoperative CRT could be illustrated in certain aspects, such as improved local control rate 25,29 and better complete resection rate. 25,28,30 The Irish trial 33 was a small randomized trial in 113 patients with AC randomized to surgery alone vs preoperative CRT with two cycles of cisplatin/fluorouracil and 40 Gy in 15 fractions. Although the study demonstrated an improved survival with preoperative CRT, the uncharacteristic poor survival in the surgery alone group (6% vs 32% at 3 years) confounded the benefit of adding CRT.…”

Section: Multimodal Therapy For Esophageal Cancermentioning

confidence: 99%

“…Neoadjuvant CRT can increase the complete resection rate for esophageal cancer, 25,28,30 with the rate of preoperative CRT that ranges from 80% to 92% compared to the rate of surgery alone that ranges from 59% to 69%. 28,30 The number of positive lymph nodes could also be reduced with preoperative CRT, 28 which is associated with good survival. [41][42][43] Preoperative CRT significantly increases the pathologic complete response (pCR) rate, ranging from 18% to 43%.…”

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confidence: 99%

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Esophageal cancer: comparative effectiveness of treatment options

Cai¹,

Lin²

2016

CER

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Esophageal cancer is a lethal disease. Multimodal therapy has improved the survival and local control for locally advanced esophageal cancer compared to surgery alone. Neoadjuvant chemoradiotherapy (CRT) plus surgery is the accepted standard of care for operable esophageal cancer. Pathologic complete response is very common, ranging from 18% to 43%, and it is an independent favorable prognostic factor for survival. Salvage surgery after definitive CRT may be safe and feasible for patients with esophageal cancer who achieve pathologic complete response after neoadjuvant CRT. For inoperable cases, definitive CRT is an alternative treatment modality. Intensity-modulated radiation therapy may reduce treatment-related toxicities due to its better dose homogeneity and conformity compared to three-dimensional conformal radiotherapy. Proton therapy can further improve target conformity and normal tissue sparing when compared to photon therapy (three-dimensional conformal radiotherapy and intensitymodulated radiation therapy) and, therefore, likely to further improve the treatment outcomes of patients. This article compares the effectiveness of the various treatment approaches in the definitive or neoadjuvant setting and reviews the evidence on the benefit of utilizing advanced radiation techniques for the curative management of esophageal cancer.

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“…Until such data are available, management decisions continue to be guided by reports on current clinical practice. Some nonrandomized and retrospective data have suggested that regional nodal control outcomes are improved with adjuvant irradiation therapy, 4,5 compared with surgical series for similar highrisk nodal presentations. [6][7][8][9] Furthermore, RT is increasingly being used in clinical practice as an adjuvant therapy for high-risk regional involvement with malignant melanoma.…”

mentioning

confidence: 99%

Role of postoperative irradiation for patients with bilateral cervical nodal metastases from cutaneous melanoma: A critical assessment

2009

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A prospective phase II study of adjuvant postoperative radiation therapy following nodal surgery in malignant melanoma–Trans Tasman Radiation Oncology Group (TROG) Study 96.06

Cited by 101 publications

References 19 publications

A retrospective analysis of the role of adjuvant radiotherapy in the treatment of cutaneous melanoma

A retrospective analysis of the role of adjuvant radiotherapy in the treatment of cutaneous melanoma

Esophageal cancer: comparative effectiveness of treatment options

Role of postoperative irradiation for patients with bilateral cervical nodal metastases from cutaneous melanoma: A critical assessment

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