The Role of Radiotherapy in the Management of Vaginal Melanoma: A Literature Review with a Focus on the Potential Synergistic Role of Immunotherapy

被引:5
作者
Cuccia, Francesco [1 ]
D'Alessandro, Salvatore [1 ,2 ]
Blasi, Livio [3 ]
Chiantera, Vito [4 ]
Ferrera, Giuseppe [1 ]
机构
[1] ARNAS Civ Hosp, Radiotherapy Unit, Radiat Oncol, I-90100 Palermo, Italy
[2] Univ Palermo, Radiat Oncol Sch, I-90100 Palermo, Italy
[3] ARNAS Civ Hosp, Med Oncol, I-90100 Palermo, Italy
[4] ARNAS Civ Hosp, Gynecol Oncol, I-90100 Palermo, Italy
关键词
vaginal melanoma; radiotherapy; immunotherapy; PRIMARY MALIGNANT-MELANOMA; CARBON ION RADIOTHERAPY; RADIATION; THERAPY;
D O I
10.3390/jpm13071142
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Among the mucosal melanomas, vaginal melanomas are very rare tumors, accounting for less than 20% of melanomas arising from the female genital tract. They occur most frequently in women in post-menopausal age, but younger patients may also experience this neoplasm, mainly located in the lower third of the vagina or the anterior wall. The optimal management of this tumor remains controversial, with surgery reported as the most frequently adopted approach. However, a clear benefit of surgical treatment in terms of survival has not yet been demonstrated. Conversely, radiotherapy may represent an attractive non-invasive alternative, and there are several favorable reports of the role of radiation therapy, either delivered with photons, brachytherapy, or hadrontherapy. A wide range of techniques and fractionation regimens are reported with substantially good tolerance to the treatment, and acute G3 or higher toxicities are reported only in the case of concurrent immunotherapy. Of note, due to the rarity of the disease, there is a lack of high-level evidence for the optimal therapeutic option. In this scenario, recent studies theorize the possibility of developing combinatorial approaches of radiotherapy with immunotherapy based on cutaneous melanomas reports. In this review, we aim to summarize the evidence available in the literature supporting the role of definitive radiotherapy for vaginal melanomas, with a focus on the combination of RT with immunotherapy, in terms of optimal timing and biological rationale.
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页数:9
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