This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Results of Treatment by Radiotherapy

Richard W. Tsang, MD; Fei-Fei Liu, MD; Woodrow Wells, MD; David G. Payne, MD

Arch Dermatol. 1994;130(8):1008-1012.

Abstract
Background and Design
Although surgical excision is considered the treatment of choice for lentigo maligna, some elderly patients presenting with large lesions in the head and neck region may not be suitable candidates for surgical management. Radiotherapy has been used for this tumor at the Princess Margaret Hospital, Toronto, Ontario, for over the past 20 years with encouraging results. Fifty-four patients treated between 1968 and 1988 were identified, and their records were reviewed to determine treatment outcome.

Results
Younger patients with smaller lesions were treated with surgical excision (n=18) and achieved an actuarial tumor control rate of 94% at 3 years. Older patients with larger lesions located in the head and neck area were treated by radiotherapy (n=36), with an actuarial tumor control rate of 86% at 5 years. Three of the four patients not achieving tumor control by radiation were successfully treated with surgical excision, and two of them proved to have malignant melanomas (both Clark's level II) when examined histologically. One patient with residual pigmentation 4 months after treatment was unavailable for follow-up. No patients developed metastatic melanoma. The late cosmetic appearance was acceptable in the majority of irradiated patients, with 11% showing poor cosmesis due to progressive skin pallor, atrophy, and telangiectasia in the treated area.

Conclusion
Conventional fractionated radiation therapy with superficial x-rays is a simple and effective method of management for lentigo maligna of the head and neck region. It is an excellent alternative treatment to surgical excision, with low morbidity and acceptable longterm cosmetic results.

(Arch Dermatol. 1994;130:1008-1012)

Author Affiliations
From the Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Ontario.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Malignant Melanoma in the 21st Century, Part 2: Staging, Prognosis, and Treatment
Markovic et al.
Mayo Clin Proc. 2007;82:490-513.
ABSTRACT | FULL TEXT  

Variation in the Diagnosis, Treatment, and Management of Melanoma In Situ: A Survey of US Dermatologists
Charles et al.
Arch Dermatol 2005;141:723-729.
ABSTRACT | FULL TEXT  

Surgical Margins for Lentigo Maligna and Lentigo Maligna Melanoma: The Technique of Mapped Serial Excision
Huilgol et al.
Arch Dermatol 2004;140:1087-1092.
ABSTRACT | FULL TEXT  

Radiotherapy for Lentigo Maligna
Huynh and Veness
Arch Dermatol 2002;138:981-982.
FULL TEXT  

Alternative Therapies for Lentigo Maligna
Journal Watch Dermatology 1994;1994:2-2.
FULL TEXT