Shi Wenyin
Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
Although melanoma is a relative radioresistant tumor, radiation therapy (RT) remains a valid and effective treatment option for the management of melanoma. RT as a primary treatment is often offered in well-defined situations, such as medical inoperability, lentiginous melanoma, mucosal melanoma, and ocular melanoma. Adjuvant RT following lymphadenectomy in node-positive melanoma patients prevents local and regional recurrence; however, the role of adjuvant RT remains controversial and underutilized due to lack of overall survival benefit. On the other hand, RT is highly effective in providing symptom palliation for metastatic melanoma and is widely used. Advanced RT technologies such as stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) can achieve excellent local control with minimum toxicities. They are commonly used in the management of brain, lung, spine, and liver metastases. Most recently, it is under active investigation on combining RT with new systemic options, such as targeted therapy, or immunotherapy. The advancements in the treatment of patients with melanoma highlight the importance of multidisciplinary management in this disease. Radiation therapy will continue to be one of the key therapeutic options.
尽管黑色素瘤是一种相对抗拒放疗的肿瘤，但放射治疗（RT）仍然是黑色素瘤治疗中一种有效的治疗选择。RT作为主要治疗手段通常适用于明确界定的情况，如医学上无法手术、雀斑样黑色素瘤、黏膜黑色素瘤和眼部黑色素瘤。在淋巴结阳性的黑色素瘤患者中，淋巴结切除术后进行辅助RT可预防局部和区域复发；然而，由于缺乏总生存获益，辅助RT的作用仍存在争议且未得到充分利用。另一方面，RT在缓解转移性黑色素瘤症状方面非常有效且被广泛应用。立体定向放射外科（SRS）和立体定向体部放疗（SBRT）等先进的RT技术能够以最小的毒性实现出色的局部控制。它们常用于脑、肺、脊柱和肝转移瘤的治疗。最近，正在积极研究将RT与新的全身治疗方案（如靶向治疗或免疫治疗）相结合。黑色素瘤患者治疗方面的进展凸显了该疾病多学科管理的重要性。放射治疗将继续成为关键的治疗选择之一。
