Somewhat lower radiation doses (300 to 400 cGy) are used for brain metastases. A new method of focused radiation (stereotactic radiotherapy) is now replacing neurosurgery in some centers for treatment of one or a low number of small brain metastases.
Hyperthermia in conjunction with radiation may improve local control of large lesions.
Biological Therapy Stimulating the immune system with biological response modifiers to reject
the tumor has already shown some degree of success, sometimes with less severe side effects than chemotherapy .
Giving moderate doses of interferon-alpha three times a week under the skin (subcutaneously) has resulted in a 10 to 20 percent response rate. Unfortunately, a complete disappearance of metastases from melanoma is rare when it is treated with interferon. Side effects experienced with interferon include fever, chills and fatigue. The high cost of interferon is a drawback, and because the treatment is so costly and the number of responses so low, it has not been released as a standard treatment in Canada.
A biologic substance called interleukin-2 (IL-2) has produced responses in approximately 20 percent of patients. As with interferon, only a small proportion of individuals have a complete disappearance of metastatic melanoma. It is not necessary to receive so-called LAK cells (IL-2 or lymphokine-activated killer cells) or very high dose IL-2 to achieve this response rate. IL-2 has not been released in Canada as a standard treatment for metastatic melanoma.
