title: Radiotherapy after surgical resection for head and neck mucosal melanoma.
abstract: OBJECTIVE
  To present our single-institution experience with postoperative radiotherapy for mucosal melanoma of the head and neck.
  
  
  METHODS
  Between 1992 and 2007, 27 patients with mucosal melanoma of the head and neck underwent surgical resection followed by postoperative radiotherapy. Median age was 68 years (range: 45-89 years). Sites included were sinonasal in 24 patients, oral cavity in 2, and oropharynx in 1. All but 2 patients had stage I disease. Twenty-two patients received hypofractionated radiation. Radiation techniques were intensity-modulated radiation therapy in 13, 3-dimensional conformal in 4, and conventional in 10.
  
  
  RESULTS
  The median follow-up for living patients was 45 months (range: 24-122 months). The 3- and 5-year estimates of local progression-free, loco-regional progression-free, distant metastasis-free, and overall survival were: 47% and 35%; 34% and 22%; 30% and 24%; and 40% and 33%, respectively. Median time to local failure and distant metastasis was 32 and 14 months, respectively. Acute toxicities included 19% with grade 2 or higher mucositis. No late complications related to the optic structures were seen.
  
  
  CONCLUSIONS
  Modern radiotherapeutic techniques including intensity-modulated radiation therapy appear feasible and well-tolerated in the postoperative treatment of head and neck mucosal melanoma. Unusual or serious late complications have not been observed despite extensive use of hypofractionated regimens. However, rates of local and distant failure remain high.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10065, USA. wua@mskcc.org
authors.forename: Abraham J
authors.initials: AJ
authors.lastname: Wu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gomez
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Zhung
authors.forename: Kelvin
authors.initials: K
authors.lastname: Chan
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Gomez
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Wolden
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zelefsky
authors.forename: Jedd D
authors.initials: JD
authors.lastname: Wolchok
authors.forename: Richard D
authors.initials: RD
authors.lastname: Carvajal
authors.forename: Paul B
authors.initials: PB
authors.lastname: Chapman
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wong
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Shaha
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Nancy Y
authors.initials: NY
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D052016:Mucositis / Q000209:etiology*; D009092:Mucous Membrane / Q000473:pathology; D009669:Nose Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology*; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016896:Treatment Outcome