1 progressive lesion of many treated melanoma mets. Previous dose 20Gy in 1 fx a year ago. 1.5 cm now with moderate vasogenic edema.
Thinking of fractionated approach. 6Gy x 5 or 9 Gy x 3. Any consensus?
This clinical case is becoming more common. I swear pre immunotherapy I never saw this. Everyone died a year later.
All I can say is get the bevacizumab ready. Works like a charm when you’re scratching your head on necrosis vs progression 3 months later.
Seems like a reasonable time frame for failure, even though the others are stable. At the same time, if something got 20 gy x 1 and possibly grew back, maybe something before/in addition to rt is the right step.The discussion of necrosis as a foregone conclusion has me bummed.