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Melanomas harbor <jats:italic>BRAF<\/jats:italic> mutations <jats:italic>(BRAF<\/jats:italic>+) in 40\u201350% of cases, the majority of which are on the V600E residue. This study sought to compare the clinical outcomes after RT between patients with <jats:italic>BRAF<\/jats:italic>+ and <jats:italic>BRAF<\/jats:italic>\u2212 melanoma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a retrospective review of 105 Stage III melanoma patients treated at our institution with LND followed by adjuvant RT from 2006 to 2019. <jats:italic>BRAF<\/jats:italic> mutational status was determined on the primary skin or nodal tissue samples from all patients. We compared characteristics of the <jats:italic>BRAF<\/jats:italic>+ and <jats:italic>BRAF<\/jats:italic>\u2212 groups using Fisher\u2019s exact test and Wilcoxon rank sum test and performed univariate and multivariate analysis using Kaplan\u2013Meier estimates, log-rank tests, and Cox proportional hazards modeling with the clinical outcomes of local\u2013regional lymph node control, distant metastasis-free survival (DMFS), recurrence-free survival (RFS), and overall survival (OS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-three (50%) patients harbored a <jats:italic>BRAF<\/jats:italic> mutation (92%, pV600E). <jats:italic>BRAF<\/jats:italic>+ patients were younger and had primary tumors more commonly found in the trunk vs head and neck compared to <jats:italic>BRAF<\/jats:italic>- patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The 5\u00a0year local\u2013regional control in the <jats:italic>BRAF<\/jats:italic>\u2009+\u2009patients was 60% compared to 81% in the <jats:italic>BRAF<\/jats:italic>- patients (HR 4.5, 95% CI 1.3\u201315.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). There were no significant differences in 5-year DMFS, RFS, and OS rates between the two <jats:italic>BRAF<\/jats:italic> patient groups. The presence of 4 or more positive LNs remained a significant prognostic factor for local\u2013regional lymph node control, RFS, and OS in multivariate analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Stage III melanoma patients with <jats:italic>BRAF<\/jats:italic> mutation treated with adjuvant RT had &gt;\u20094 times increased risk of local recurrence or regional lymph node recurrence. These results could be useful for adjuvant RT consideration in lymph node positive melanoma patients and supports other data that BRAF mutation confers radiation resistance.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13014-021-01903-5","type":"journal-article","created":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T10:03:31Z","timestamp":1631959411000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["BRAF mutation correlates with worse local\u2013regional control following radiation therapy in patients with stage III melanoma"],"prefix":"10.1186","volume":"16","author":[{"given":"Adam R.","family":"Wolfe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyanka","family":"Chablani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Siedow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Walston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari L.","family":"Kendra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Wuthrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1020-0845","authenticated-orcid":false,"given":"Terence M.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,9,18]]},"reference":[{"key":"1903_CR1","doi-asserted-by":"crossref","unstructured":"Gershenwald JE, Scolyer RA, Hess KR, Sondak VK, Long GV, Ross MI, Lazar AJ, Faries MB, Kirkwood JM, McArthur GA et al: Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. 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