adjuvant radiation therapy in treating patients with resected desmoplastic melanoma

Conditions: Recurrent Melanoma

Summary: this phase ii trial is studying how well adjuvant radiation therapy works in treating patients who have undergone surgery for desmoplastic melanoma. radiation therapy uses high-energy x-rays to damage tumor cells. giving radiation therapy after surgery may kill any tumor cells remaining after surgery.

primary objectives: i. assess the recurrence rates in patients with desmoplastic melanoma (dm) \>= 1 mm deep treated with adjuvant radiotherapy after surgical resection. ii. assess recurrence rates in patients with locally recurrent dm treated with adjuvant radiotherapy after surgical resection. secondary objectives: i. evaluate the impact of adjuvant radiation therapy after surgical resection on disease free and overall survival. ii. evaluate the immediate and long-term morbidity of the addition of radiotherapy to surgery. outline: within 8 weeks after surgical resection, patients undergo radiation therapy twice weekly over approximately 2.5 weeks for a total of 5 fractions in the absence of disease progression or unacceptable toxicity. after completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 3 years.

Eligibility criteria:
inclusion criteria * eastern cooperative oncology group (ecog) performance status (ps) 0, 1, or 2 * pathologically proven dm \>= 1 mm in depth or locally recurrent dm; recurrent tumor is defined as a tumor found =\< 2 cm from the previous excision or within the surgical bed (which includes the extent of previous skin flaps) * dm resected with pathologically negative margins; acceptable surgery includes standard wide local excision and moh's surgery * tumors on the trunk proximal extremities need to have a \>= 2 cm negative margin; tumors located on the head and neck and distal extremities will have an attempt at 2 cm negative margins but due to location and subsequent concern regarding cosmesis a margin \< 2 cm will be acceptable if margin is negative * margins from tumors resected using the moh's technique will be accepted if negative and best approximation of tumor width will be made * radiation therapy (rt) is to begin =\< 8 weeks after definitive surgical resection * adjuvant systemic therapy (immunotherapy or chemotherapy) must be postponed until irradiation is completed exclusion criteria * previous irradiation to the same site * non-healing surgical wound * active infection at the surgical site * evidence of metastatic disease; local nodal disease is still eligible for the trial * life expectancy \< 1 year * melanoma with focally desmoplastic features, in which the desmoplastic melanoma is not the predominant histologic pattern of the tumor, will be excluded; non-desmoplastic neurotropic melanoma and non-desmoplastic spindle cell melanoma are also excluded * previous malignancy \< 5 years excluding basal cell carcinoma or squamous cell carcinoma of the skin or cervical carcinoma in situ (with the exception of patients who have stage i breast cancer who were adequately treated with adjuvant therapy and are currently disease free, and patients with stage i or ii prostate cancer treated with prostatectomy or radiotherapy and are biochemically free of disease \[for radical retropubic prostatectomy (rrp) prostate-specific antigen (psa) \< 0.3 and for radiotherapy psa \< 2.0 above the post treatment nadir\]) * any of the following: * pregnant women * women of childbearing potential who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device \[iud\], surgical sterilization, abstinence, etc.)

Keywords: recurrent melanoma stage i melanoma stage ii melanoma stage iii melanoma