In the landscape of Stage III locoregionally advanced cutaneous melanoma treatment, the post-immunotherapy era has sparked a number of questions on the management of the nodal basin. However, much of the available literature is not focused on radiation therapy as an adjuvant therapy. This literature review aims to illuminate the evidence surrounding radiation therapy’s potential to mitigate regional recurrences in the adjuvant setting for melanoma. Additionally, it seeks to identify adjunct systemic therapy options and explore the synergy between systemic therapy and radiation. Despite strides in surgical techniques and systemic therapies, controlling regional Stage III melanoma remains a formidable clinical hurdle. While historical data strongly suggest the efficacy of adjuvant radiation therapy in reducing regional recurrence risk, its evaluation predates the advent of MAPK pathway inhibitors and robust immunotherapy options. Notably, clinical trials have yet to definitively demonstrate a survival advantage with adjuvant radiation therapy. Additional research should focus on refining the definition of high risk for regional recurrence through gene expression profiling or tumor immune profiling scores and elucidate the optimal role of adjuvant radiation therapy in patients treated with neoadjuvant systemic therapy.
在III期局部晚期皮肤黑色素瘤的治疗领域中，免疫治疗时代的到来引发了许多关于淋巴结区域管理的疑问。然而，现有文献大多未将放射治疗作为辅助治疗手段进行重点探讨。本文献综述旨在阐明放射治疗在黑色素瘤辅助治疗中降低区域复发风险的证据基础，同时试图确定辅助性全身治疗方案，并探索全身治疗与放射治疗之间的协同作用。尽管外科技术和全身治疗已取得显著进展，但控制III期黑色素瘤的区域性病变仍是临床上面临的重大挑战。历史数据虽有力支持辅助放射治疗在降低区域复发风险方面的有效性，但这些评估早于MAPK通路抑制剂和强效免疫治疗方案的出现。值得注意的是，临床试验尚未明确证实辅助放射治疗能带来生存获益。未来研究应着重通过基因表达谱或肿瘤免疫评分系统完善区域复发高风险的定义，并阐明辅助放射治疗在接受新辅助全身治疗患者中的最佳作用。
肿瘤(癌症)患者之家