Case report
peer-reviewed

CyberKnife® Treatment of Metastatic Malignant Melanoma as Part of a Multimodality Therapy



Abstract

Metastatic malignant melanoma is an incurable disease with a median survival of 8.5 months and a probability of surviving five years after the diagnosis of less than 5%. To date, no systemic therapy has meaningfully changed these survival end points. A case of metastatic melanoma treated with combined modalities including image-guided robotic radiosurgery with CyberKnife® (Accuray Incorporated, Sunnyvale, CA, USA), and has an overall survival of 14 years is presented.

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References

  1. Jemal A, Siegel R, Ward E, et al.: Cancer statistics. CA Cancer J. Clin. 2008, 58:71-96. 10.3322/CA.2007.0010
  2. Garbe C, Leiter U: Melanoma epidemiology and trends. Clin. Dermatol. 2009, 27:3-9. 10.1016/j.clindermatol.2008.09.001
  3. Bellett RE, Mastrangelo MJ, Laucius JF, Bodurtha AJ: Randomized prospective trial of DTIC (NSC-45388) alone versus BCNU (NSC-409962) plus vincristine (NSC-67574) in the treatment of metastatic malignant melanoma. Cancer Treat Rep. 1976, 60:595-600.
  4. Stevens MF, Hickman JA, Langdon SP, et al.: Antitumor activity and pharmacokinetics in mice of 8-carbamoyl-3-methyl-imidazo[5,1-d]-1,2,3,5-tetrazin-4(3H)-one (CCRG 81045; M & B 39831), a novel drug with potential as an alternative to dacarbazine. Cancer Res. 1987, 47:5846-5852.
  5. Middleton MR, Grob JJ, Aaronson N, et al.: Randomized Phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J. Clin. Oncol. 2000, 18:158-166.
  6. Tsao H, Sober AJ: Melanoma treatment update. Dermatol. Clin. 2005, 23:323-333. 10.1016/j.det.2004.09.005
  7. Jacquillat C, Khayat D, Banzet P, et al.: Final report of the French multicenter Phase II study of the nitrosourea fotemustine in 153 evaluable patients with disseminated malignant melanoma including patients with cerebral metastases. Cancer. 1990, 66:1873-1878.
  8. Jacquillat C, Khayat D, Banzet P, et al.: Chemotherapy by fotemustine in cerebral metastases of disseminated malignant melanoma. Cancer Chemother. Pharmacol. 1990, 25:263-266. 10.1007/BF00684883
  9. Avril MF, Aamdal S, Grob JJ, et al.: Fotemustine compared with dacarbazine in patients with disseminated malignant melanoma: a Phase III study. J. Clin. Oncol. 2004, 22:1118-1125. 10.1200/JCO.2004.04.165
  10. Bedikian AY, Weiss GR, Legha SS, et al.: Phase II trial of docetaxel in patients with advanced cutaneous malignant melanoma previously untreated with chemotherapy. J. Clin. Oncol. 1995, 13:1895-2899.
  11. Einzig AI, Hochster H, Wiernik PH, et al.: A Phase II study of taxol in patients with malignant melanoma. Invest. New Drugs. 1991, 9:59-64. 10.1007/BF00194546
  12. Einzig AI, Schuchter LM, Recio A, et al.: Phase II trial of docetaxel (Taxotere) in patients with metastatic melanoma previously untreated with cytotoxic chemotherapy. Med. Oncol. 1996, 13:111-117. 10.1007/BF02993861

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Case report
peer-reviewed

CyberKnife® Treatment of Metastatic Malignant Melanoma as Part of a Multimodality Therapy


Author Information

William T. Brown Corresponding Author

Miami Cyberknife; University of Miami Miller School of Medicine, Miami, FL

Fahed Fayed

CyberKnife Center of Miami; Radiation Oncology Department, University of Miami Hospital & Clinics, Miami, FL

Xiaodong Wu

CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL

James M. Hevezi

Austin CyberKnife Center, Austin, TX

Irene Monterroso

CyberKnife Center of Miami, Miami, FL

James G. Schwade

CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: The authors have declared that no conflicts of interest exist.

Acknowledgements

All authors contributed to drafting the manuscript and all authors reviewed and approved the final manuscript.


Case report
peer-reviewed

CyberKnife® Treatment of Metastatic Malignant Melanoma as Part of a Multimodality Therapy


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Case report peer-reviewed

CyberKnife® Treatment of Metastatic Malignant Melanoma as Part of a Multimodality Therapy

  • Author Information
    William T. Brown Corresponding Author

    Miami Cyberknife; University of Miami Miller School of Medicine, Miami, FL

    Fahed Fayed

    CyberKnife Center of Miami; Radiation Oncology Department, University of Miami Hospital & Clinics, Miami, FL

    Xiaodong Wu

    CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL

    James M. Hevezi

    Austin CyberKnife Center, Austin, TX

    Irene Monterroso

    CyberKnife Center of Miami, Miami, FL

    James G. Schwade

    CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: The authors have declared that no conflicts of interest exist.


    Article Information

    Published: May 26, 2011

    DOI

    10.7759/cureus.27

    Cite this article as:

    Brown W T, Fayed F, Wu X, et al. (2011-05-26 02:24:31 UTC) CyberKnife® Treatment of Metastatic Malignant Melanoma as Part of a Multimodality Therapy. Cureus 3(5): e27. doi:10.7759/cureus.27

    Publication history

    Published: May 26, 2011

    Copyright

    © Copyright 2011
    Brown et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Metastatic malignant melanoma is an incurable disease with a median survival of 8.5 months and a probability of surviving five years after the diagnosis of less than 5%. To date, no systemic therapy has meaningfully changed these survival end points. A case of metastatic melanoma treated with combined modalities including image-guided robotic radiosurgery with CyberKnife® (Accuray Incorporated, Sunnyvale, CA, USA), and has an overall survival of 14 years is presented.

This article is currently in transition to our new journal format. This button will take you to the existing view until this article is converted.

View

References

  1. Jemal A, Siegel R, Ward E, et al.: Cancer statistics. CA Cancer J. Clin. 2008, 58:71-96. 10.3322/CA.2007.0010
  2. Garbe C, Leiter U: Melanoma epidemiology and trends. Clin. Dermatol. 2009, 27:3-9. 10.1016/j.clindermatol.2008.09.001
  3. Bellett RE, Mastrangelo MJ, Laucius JF, Bodurtha AJ: Randomized prospective trial of DTIC (NSC-45388) alone versus BCNU (NSC-409962) plus vincristine (NSC-67574) in the treatment of metastatic malignant melanoma. Cancer Treat Rep. 1976, 60:595-600.
  4. Stevens MF, Hickman JA, Langdon SP, et al.: Antitumor activity and pharmacokinetics in mice of 8-carbamoyl-3-methyl-imidazo[5,1-d]-1,2,3,5-tetrazin-4(3H)-one (CCRG 81045; M & B 39831), a novel drug with potential as an alternative to dacarbazine. Cancer Res. 1987, 47:5846-5852.
  5. Middleton MR, Grob JJ, Aaronson N, et al.: Randomized Phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J. Clin. Oncol. 2000, 18:158-166.
  6. Tsao H, Sober AJ: Melanoma treatment update. Dermatol. Clin. 2005, 23:323-333. 10.1016/j.det.2004.09.005
  7. Jacquillat C, Khayat D, Banzet P, et al.: Final report of the French multicenter Phase II study of the nitrosourea fotemustine in 153 evaluable patients with disseminated malignant melanoma including patients with cerebral metastases. Cancer. 1990, 66:1873-1878.
  8. Jacquillat C, Khayat D, Banzet P, et al.: Chemotherapy by fotemustine in cerebral metastases of disseminated malignant melanoma. Cancer Chemother. Pharmacol. 1990, 25:263-266. 10.1007/BF00684883
  9. Avril MF, Aamdal S, Grob JJ, et al.: Fotemustine compared with dacarbazine in patients with disseminated malignant melanoma: a Phase III study. J. Clin. Oncol. 2004, 22:1118-1125. 10.1200/JCO.2004.04.165
  10. Bedikian AY, Weiss GR, Legha SS, et al.: Phase II trial of docetaxel in patients with advanced cutaneous malignant melanoma previously untreated with chemotherapy. J. Clin. Oncol. 1995, 13:1895-2899.
  11. Einzig AI, Hochster H, Wiernik PH, et al.: A Phase II study of taxol in patients with malignant melanoma. Invest. New Drugs. 1991, 9:59-64. 10.1007/BF00194546
  12. Einzig AI, Schuchter LM, Recio A, et al.: Phase II trial of docetaxel (Taxotere) in patients with metastatic melanoma previously untreated with cytotoxic chemotherapy. Med. Oncol. 1996, 13:111-117. 10.1007/BF02993861
William T. Brown, M.D.

Miami Cyberknife; University of Miami Miller School of Medicine, Miami, FL

For correspondence:
brow5417@bellsouth.net

Fahed Fayed

CyberKnife Center of Miami; Radiation Oncology Department, University of Miami Hospital & Clinics, Miami, FL

Xiaodong Wu, Ph.D.

CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL

James M. Hevezi, Ph.D.

Austin CyberKnife Center, Austin, TX

Irene Monterroso, Ph.D.

CyberKnife Center of Miami, Miami, FL

James G. Schwade, M.D.

CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL

William T. Brown, M.D.

Miami Cyberknife; University of Miami Miller School of Medicine, Miami, FL

For correspondence:
brow5417@bellsouth.net

Fahed Fayed

CyberKnife Center of Miami; Radiation Oncology Department, University of Miami Hospital & Clinics, Miami, FL

Xiaodong Wu, Ph.D.

CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL

James M. Hevezi, Ph.D.

Austin CyberKnife Center, Austin, TX

Irene Monterroso, Ph.D.

CyberKnife Center of Miami, Miami, FL

James G. Schwade, M.D.

CyberKnife Center of Miami; University of Miami Miller School of Medicine, Miami, FL