How would you manage recurrent popliteal and inguinal LNs from melanoma?

In a patient with a history of a RLE melanoma s/p WLE and right ILND, how would you treat nodal recurrence?

What are the surgical vs non-surgical options?

What radiation dose and fractionation scheme would be appropriate?

Answer from: Radiation Oncologist at Academic Institution

1. Confirm no distant metastases. 2. Therapeutic lymphadenectomy if possible, followed by adjuvant lymph node basin radiotherapy, 48 Gy/20 fractions or equivalent in 2 Gy fractions. If BRAF altered, consider adjuvant dabrafenib/trametinib. If not BRAF altered, consider adjuvant ipilimumab. 3. If u...

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Radiation Oncologist at Fort Bend Medical and Diagnostic Center
Thank you.

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How would you manage recurrent popliteal and inguinal LNs from melanoma?

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