The Florida Melanoma Trial I : A Prospective Multicenter Phase III Trial of Postoperative Hypofractionated Adjuvant Radiotherapy with Concurrent Interferon-Alfa-2b in the Treatment of Advanced Stage III Melanoma with Long-Term Toxicity Follow-Up

Abstract EN

Radiotherapy (RT) and interferon-alfa-2b (IFN α-2b) have individually been used for adjuvant therapy stage III melanoma with high-risk pathologic features.

We hypothesized that concurrent adjuvant RT and IFN α-2b may decrease the risk of regional recurrence following surgery with acceptable toxicity.

A prospective multicenter phase I/II study was conducted to evaluate hypofractionated RT with concurrent IFN.

Induction IFN α-2b, 20 MU/m2/d, was administered IV ×5 consecutive days every week for 4 weeks.

Next, RT 30 Gy in 5 fractions was given with concurrent IFN α-2b, 10 MU/m2 SQ 3 times per week on days alternating with RT.

Subsequent maintenance therapy consisted of adjuvant IFN α-2b, 10 MU/m2 SQ 3 times per week to a total of 1 year.

To fully evaluate patterns of failure, long-term follow-up was conducted for up to 10 years.

A total of 29 consenting patients were enrolled between August 1997 and March 2000.

The maximum (worst) grade of acute nonhematologic toxicity during concurrent RT/IFN α-2b (and up to 2 weeks post RT) was grade 3 skin toxicity noted in 2 patients (9%).

Late effects were limited.

Probability of regional control was 78% (95% CI: 55%–90%) at 12 months.

The median follow-up (range) was 80 (51–106) months among ten survivors (43%).

The median overall survival was 34.5 months while the median failure-free survival was 19.9 months.

Postoperative concurrent hypofractionated RT with IFN α-2b for advanced stage III melanoma appears to be associated with acceptable toxicity and may provide reasonable in-field control in patients at high risk of regional failure.