Superficial hyperthermia combined with hypofractionated radiotherapy of malignant melanoma metastases to skin and lymph nodes

Aim: The evaluation of combined radiohyperthermia in the treatment of skin and lymph nodes malignant melanoma metastases. Material and method: Material comprises 10 skin and 11 lymph nodes melanoma metastases (13 patients) treated with combined superficial hyperthermia and irradiation. The tumor diameter before the treatment varied from 0.5 to 7 cm (mean 2.9). All patients were treated using three 1 hour hyperthermia sessions and three 9 Gy radiation doses delivered within 8 days. The follow up period varied from 1 to 18 months (mean 4.6). Patients were examined on the day of treatment completion, 2 and 6 weeks later and next every three months. The skin reaction and tumor regression were evaluated. Impact of different biological factors for skin reaction and treatment result were checked. Results: The most frequent skin reaction was erythrema (51% of cases on the day of treatment end) and blisters (19% of cases 6 weeks after the treatment). Means of tumor diameter 0.5, 1.5, and 4.5 months after the treatment were 2.3, 2.3 and 2.4 cm, respectively. The biggest percentage of complete regressions was observed 1.5 and 4.5 months after the treatment, 33.5% and 43%, respectively. Significant dependencies between skin reaction 2 weeks after the treatment and red blood cells count in this time and before the treatment were found. Conclusion: The combined radiohyperthermia is safe and effective treatment modality of superficial melanoma metastases and could be an alternative for palliative surgery.