Radiotherapy after surgical resection for head and neck mucosal melanoma.
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.
Wu
Abraham J
AJ
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10065, USA. wua@mskcc.org
Gomez
Jennifer
J
Zhung
Joanne E
JE
Chan
Kelvin
K
Gomez
Daniel R
DR
Wolden
Suzanne L
SL
Zelefsky
Michael J
MJ
Wolchok
Jedd D
JD
Carvajal
Richard D
RD
Chapman
Paul B
PB
Wong
Richard J
RJ
Shaha
Ashok R
AR
Kraus
Dennis H
DH
Shah
Jatin P
JP
Lee
Nancy Y
NY
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