How would you approach radiation treatment of recurrent, BRAF-negative melanoma with left distal leg metastases and two isolated PET-avid inguinal nodes?

The index lesion was located inferior to the left knee and excised appropriately, with an additional in-transit metastasis in the left mid leg. The patient is planned to receive immunotherapy.

Answer from: Radiation Oncologist at Academic Institution

Excise gross disease. Consider adjuvant immunotherapy, and adjuvant RT to node basin if there are high risk nodes (>4 cm, extracapsular extension, >2 involved nodes).

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How would you approach radiation treatment of recurrent, BRAF-negative melanoma with left distal leg metastases and two isolated PET-avid inguinal nodes?

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