Please select the option that best describes you:
Topics:
Radiation Oncology • Neuro-Oncology
How do you manage a large surgical cavity following resection of a melanoma brain metastasis?
Do you give SRS/fSRS or would you ever elect to closely observe if the patient is receiving immunotherapy/targeted agents?
I find postop that these large cavities have high risk of radiation necrosis and I'm afraid 30Gy/5 fx is not enough to control melanoma cells anyway so tend to feel we should observe these and treat at recurrence but wondering if anyone has similar experience or data to support this? It seems to me that RN is a big issue requiring steroids that will counteract any IO therapy?
Answer from: Radiation Oncologist at Community Practice
I've used 30 Gy in 5 fx before for a cerebellar melanoma cavity about 4.5x3 cm. It's much less likely to cause necrosis and edema than single fx. There may be some local enhancement of IO response.
Regarding immunotherapy, I don't give steroids unless symptoms occur, and try to keep it to no more t...
Sign in or Register to read more