Types of Radiation Therapy by Stage
Stage IV Patients with Brain Metastases
Stage III Patients
Which Patients: Those who are at high risk for tumor recurrence in and around the lymph node region because they have multiple affected nodes (≥3 nodes), or large nodes (>3 cm), or lymph nodes with extracapsular extension. Also, patients who have tumors that are hard to remove because of their location. These include thick tumors or those on the head and neck where the surgeon is unable to get an adequate margin around the tumor.
Purpose: For those with multiple or large nodes, radiotherapy is used after surgery to prevent the tumors from returning. If tumors are hard to remove, radiotherapy can be used to control the disease locally.
How it Works: Radiation damages both normal cells and cancer cells, but normal cells are better able repair themselves. With adjuvant therapy, radiation is given to help prevent cancer cells from growing back in that region.
How It's Given: External Beam Radiation Therapy refers to radiation that is coming from an energy source outside the body and is directed to a target inside the body.
- Patients receive treatment in a hospital or at an outpatient treatment center.
- In most cases, a linear accelerator, a high-energy x-ray machine, directs radiation to the affected area.
- A total dose of external beam radiation therapy is fractionated, or divided into several smaller doses (fractions), over a period of days (conventional fractionation).
- Treatment lasts a few minutes at a time, usually for 5 days a week over the course of 2 weeks.
- Hypofractionation, is one of the treatments that is being explored to see the effectiveness of giving higher doses of radiation in fewer treatments, and the delivery of more than one dose of radiation within the same day.
Effectiveness: Radiation therapy does improve the control of resected disease in patients with high-risk features. However, it has not been shown to reduce the risk of distant disease.
Side Effects: The side effects of radiation therapy vary by location on the body, but can include hearing loss, skin breakdown, bone exposure, ear pain, hair loss, and lymphedema.
Stage IV Patients
Which Patients: Those whose melanoma has spread to the bones or other parts of the body, or where there is a solitary tumor.
Purpose: May relieve symptoms by shrinking the tumors. Where there is a single tumor it is hoped that in partnership with newer medical treatments, this may prolong survival.
How it Works: Radiation damages both normal cells and cancer cells, but normal cells are better able repair themselves. Radiation is given to help shrink the tumors and with the goal of relieving symptoms.
How It's Given: External Beam Radiation Therapy refers to radiation that is coming from an energy source outside the body and is directed to a target inside the body.
- Patients receive treatment in a hospital or at an outpatient treatment center.
- In most cases, a linear accelerator, a high-energy x-ray machine, directs radiation to the affected area.
- A total dose of external beam radiation therapy is fractionated, or divided into several smaller doses (fractions), over a period of days (conventional fractionation).
- Treatment lasts a few minutes at a time, usually for 5 days a week over the course of 2 weeks.
- Hypofractionation, is one of the treatments that is being explored to see the effectiveness of giving higher doses of radiation in fewer treatments and the delivery of more than one dose of radiation within the same day.
Effectiveness: Radiation therapy is used with the goal of relieving symptoms. This is called palliative therapy. The radiation therapy is not expected to cure the cancer but it may help shrink it for a period of time.
Side Effects: The side effects of radiation therapy vary by location on the body, but can include hearing loss, skin breakdown, bone exposure, ear pain, hair loss, and lymphedema.
Stage IV Patients with Brain Metastases
Purpose: To control the growth of or shrink melanoma tumors in the brain in a precise manner to maximize effectiveness while minimizing side effects.
How it Works:
- SRS (stereotactic radiosurgery) uses several powerful beams of radiation located at different angles around the head which come together to focus precisely on the tumor.
- Gamma Knife is one of the most advanced forms of SRS. The "knife" is formed by 201 intersecting beams of gamma radiation that deliver a concentrated dose to a precise area of the brain.
- This noninvasive procedure is the preferred treatment for metastatic brain tumors that were previously considered inoperable or very high risk for standard brain surgery.
How It's Given:
- Prior to the operation, imaging techniques including CT scans and MRIs are used to pinpoint tumor location.
- One treatment session and one overnight hospitalization are all that are required. Gamma knife radiosurgery is available at many major medical centers.
- SRS is most effective when there are only a few small metastases. Typically, patients who have too many brain metastases to be suitable for SRS may be treated with whole brain radiation (WBXRT).
Effectiveness: For certain patients, SRS followed by whole brain radiation provides useful palliation and may prolong survival.
Side Effects: SRS has less side effects than more diffuse radiation but still can cause hair loss, hearing loss, memory problems, and speech problems, depending on the location of the brain tumor.
To read more about the treatment of brain metastases click here.
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