NCCN Guidelines for Patients
Melanoma, Version 1.2014
Principles of radiation therapy
Radiation therapy is the use of high-energy rays to destroy cancer cells. For melanoma, radiation
therapy is most commonly used as palliative treatment or to treat brain metastases. Stereotactic
radiosurgery is a type of radiation often used for brain metastases. (Read Part 4 on page 40
for details.) Palliative treatment is treatment given to relieve the symptoms caused by cancer.
Palliative radiation therapy may be used to treat the symptoms caused by metastatic melanoma.
Palliative radiation therapy may also be used for lymph node, satellite, or in-transit metastases
that can’t be treated with surgery. A wide range of radiation doses and schedules are effective.
In selected patients, adjuvant radiation therapy may be used to treat the tissue around the first
(primary) melanoma tumor after wide excision based on certain factors. These factors include
desmoplastic melanoma removed with narrow surgical margins, local recurrence, or extensive
neurotropism. Neurotropism is when the melanoma cells are able to invade nerves.
Adjuvant radiation therapy may also sometimes be used for regional melanoma if it’s likely that
the cancer will return in the area where nearby (regional) lymph nodes were removed. This area
is called the nodal basin. Adjuvant radiation may be considered for selected patients after lymph
node surgery based on certain features of the lymph node metastases.
Adjuvant radiation may reduce the risk of lymph node recurrence. However, it can cause serious
long-term side effects that may have a negative impact on quality of life. It is important to fully
understand these risks and weigh them against the benefits when considering this treatment.