The use of high dose rate brachytherapy palliation after failed palliative external beam radiotherapy for a cutaneous malignant melanoma of the foot: a case report.

Abstract

While surgery is the mainstay of therapy for primary cutaneous melanoma, some very locally advanced lesions are either unresectable or the morbidity of resection is unacceptably high in the setting of metastatic disease. These types of primary melanomas must be addressed with alternative measures including chemotherapy, immunotherapy, radiotherapy, or a combination of the above. We treated a cutaneous lesion palliatively with high dose rate brachytherapy after having minimal tumor response to external beam radiation therapy. The tumor regressed after treatment, but a new lesion subsequently developed in its previous location. High dose rate brachytherapy may have a substantial impact on the management of cutaneous lesions, but further studies on its efficacy and toxicity must be evaluated.