{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:09:57Z","timestamp":1788869397193,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Adjuvant radiotherapy (RT) may improve in-field regional tumor control in melanoma following resection of lymph node macrometastases. However, no significant effect on recurrence-free survival or overall survival has been demonstrated. The approval of adjuvant systemic immune checkpoint inhibitors and targeted therapies has significantly impacted the role of adjuvant RT. Its use in clinical practice has decreased, with heterogeneous treatment indications and approaches observed across institutions and regions. Objectives: The aim of the present study was to characterize the population of melanoma patients still undergoing adjuvant RT in the era of modern adjuvant systemic treatments, and to outline potential clinical scenarios in which it may continue to play a role in the future. Patients and methods: Fifty-eight patients treated with adjuvant RT were identified in five participating Austrian and Swiss dermato-oncologic centers. Treatment timing, toxicity, recurrence patterns, and survival outcomes were analyzed, and compared to 88 stage-matched, non-irradiated patients from a German cohort of patients who met formal RT criteria. Results: The majority of irradiated patients (53.5%) received RT before systemic therapy. The concurrent administration of adjuvant systemic therapy and radiotherapy did not increase the frequency of RT-associated toxicities (77.8% vs. 74.2%, p = 0.456). No significant differences in recurrence-free survival or overall survival were observed between irradiated and non-irradiated patients (p = 0.725 and p = 0.986, respectively). Conclusions: Although still recommended in certain melanoma guidelines, adjuvant RT is infrequently performed in the era of modern systemic treatments. Due to its exclusively locoregional efficacy, the application of adjuvant RT should be limited to clearly defined scenarios where systemic treatment options are limited and locoregional control is most important. The concurrent administration of adjuvant RT and systemic therapy is safe and should be preferred if a combined treatment strategy is chosen.<\/jats:p>","DOI":"10.3390\/cancers18182901","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:23:51Z","timestamp":1788866631000},"page":"2901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Value of Adjuvant Radiotherapy in the Treatment of Melanoma: A Multi-Center Analysis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2771-4041","authenticated-orcid":false,"given":"Magdalena","family":"Fischer","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Gerum","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falk","family":"Roeder","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University, 5020 Salzburg, Austria"},{"name":"Institute of Research and Development of Advanced Radiation Technologies (radART), Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0210-5065","authenticated-orcid":false,"given":"Matthias","family":"Brandlmaier","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Krecu","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8602-0878","authenticated-orcid":false,"given":"Julia Maria","family":"Ressler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Medical University Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Hoeller","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Medical University Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Medical University Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Therese","family":"Dernoscheg","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Medical University Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6930-6997","authenticated-orcid":false,"given":"Marina","family":"Wanner","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venerology and Allergology, Medical University Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Lanbach","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Medical University Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van Anh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venerology and Allergology, Medical University Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentia","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2279-6906","authenticated-orcid":false,"given":"Reinhard","family":"Dummer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"Department of Dermatology, Kantonsspital Aarau, 5001 Aarau, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Egger","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6085-9170","authenticated-orcid":false,"given":"Johann W.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Schumann","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-3567","authenticated-orcid":false,"given":"Christian","family":"Posch","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, 81675 Munich, Germany"},{"name":"Faculty of Medicine, Sigmund Freud University Vienna, 1020 Vienna, Austria"},{"name":"Department for Dermatology, Clinic Hietzing, Vienna Healthcare Group, 1010 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-2780","authenticated-orcid":false,"given":"Peter","family":"Koelblinger","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/S1470-2045(15)00187-4","article-title":"Adjuvant lymph-node field radiotherapy versus observation only in patients with melanoma at high risk of further lymph-node field relapse after lymphadenectomy (ANZMTG 01.02\/TROG 02.01): 6-year follow-up of a phase 3, randomised controlled 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