Commentary (Kirkwood et al): Radiotherapy for Cutaneous Malignant Melanoma: Rationale and Indications

Radiotherapy is a standard recourse in the treatment of inoperable metastatic disease of bone and brain. The control of brain metastases with radiosurgery produces excellent results, and this strategy has progressively replaced initial surgery.[1] Radiotherapy of advanced primary lesions that are incompletely operable and lymph node metastases that are unresectableor recurrences that develop after systemic metastases are already evident-has also become part of standard practice, based on significant palliation that has not required prospective randomized controlled trials for validation. Despite these wellestablished precedents, elective radiotherapy of nodal basins is quite another matter, for which high-level data (that might permit its recommendation in routine practice) do not exist.