Vaginal Mucosal Melanoma: a Complete Remission after Immunotherapy and '0-7-21' Radiotherapy Regimen (24 Gy/3 fractions/21 days)

Abstract

We present the case of a patient with vaginal mucosal melanoma who underwent complete remission after immunotherapy and '0-7-21' radiotherapy regimen (24 Gy/3 fractions/21 days). An 80-year-old woman had a biopsy of a voluminous vaginal lesion and received a histological diagnosis of melanoma with angiomatoid aspects. The patient underwent immunotherapy with pembrolizumab 2 mg/kg every 3 weeks and was sent to our attention for planning radiotherapy as the extent of the lesion did not make it susceptible to surgery.Considering the concomitant administration of pembrolizumab, we chose to treat this patient with a modulated intensity radiation therapy technique delivering a hypofractionated dose of 24 Gy in 3 fractions delivered on days 0, 7, and 21. We observed a complete clinical remission of the melanoma 12 months after radiotherapy and she has been alive for 18 months with no clinical signs of local recurrence.

Keywords: cancer; hypofractionation; immunotherapy; melanoma; radiotherapy.