The Use of Adjuvant Radiation Therapy for Curatively Resected Cutaneous Melanoma

Guideline Objective

To determine when adjuvant radiation therapy (RT) should be considered for stage I-III melanoma patients following resected curative treatment.

Patient Population

Patients diagnosed with stage I-III cutaneous melanoma who have received curative resection of their melanoma. The target population includes both patients diagnosed with primary melanoma and those with recurrence at the primary site or nodal recurrence.

Intended Guideline Users

All members of the multidisciplinary melanoma team, including radiation oncologists, medical oncologists, surgeons, and dermatologists.

Research Question(s)

1. Is adjuvant RT to the primary site appropriate after resected curative treatment for primary melanoma?
   
   1. In patients with melanoma?
   2. In patients with desmoplastic/neurotropic melanoma?
   3. In patients with primary melanoma with satellites?
2. Is adjuvant RT to the regional nodal basin appropriate after resected curative treatment in patients at high risk for regional recurrence of melanoma?
3. Is adjuvant RT appropriate after resected curative treatment for in-transit primary melanomas?
4. Is adjuvant RT appropriate after curatively resected treatment for recurrent melanoma?
   
   1. For recurrence at the primary site?
   2. For in-transit recurrence?
   3. For recurrence within the lymph node basin?
5. Does a standard RT fractionation schedule provide equivalent disease control compared with a hypofractionated schedule?