A Multicenter Study of Carbon-Ion Radiotherapy for Mucosal Melanoma of the Head and Neck: Sub-analysis of the Japan Carbon-Ion Radiotherapy Study Group (J-CROS) Study (1402 HN)

Publication date: Available online 26 December 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Masashi Koto, Yusuke Demizu, Jun-ichi Saitoh, Hiroaki Suefuji, Hiroshi Tsuji, Tomoaki Okimoto, Tatsuya Ohno, Yoshiyuki Shioyama, Ryo Takagi, Kenji Nemoto, Takashi Nakano, Tadashi Kamada
PurposeThe prognosis of patients with mucosal melanoma of the head and neck (MMHN) is poor, even for those with operable tumors, because of frequent local recurrence and metastasis. We evaluated the efficacy and safety of carbon-ion radiotherapy (C-ion RT) for MMHN in the xxxx.Methods and MaterialsMMHN patients with N0-1M0 status who were treated with C-ion RT at 4 institutions in xxxx between November 2003 and December 2014 were analyzed retrospectively. Two hundred and sixty patients (male, 111; female, 149; median age, 68 years) with histologically proven MMHN were enrolled.ResultsPrimary sites included the nasal cavity in 178 patients, paranasal sinuses in 43, oral cavity in 27, and pharynx in 12. Eighty-six patients had T3 tumors, 147 had T4a tumors, and 27 had T4b tumors. Two hundred and fifty-one patients were diagnosed with N0 disease, and 9 with N1 disease. The median total dose and number of fractions were 57.6 Gy RBE (relative biological effectiveness) and 16, respectively. Chemotherapy including dimethyl traizeno imidazole carboxamide was used concurrently in 129 patients. The median follow-up duration was 22 months (range, 1–132 months). The 2-year overall survival and local control rates were 69.4% and 83.9%, respectively. Multivariate analysis showed that gross tumor volume and concurrent chemotherapy were significant prognostic factors for overall survival. Grade 3 and Grade 4 late morbidities were observed in 27 and 7 patients (5 developed ipsilateral blindness, 1 mucosal ulcer, and 1 second malignant disease in the irradiated volume), respectively. No patients developed Grade 5 late morbidities.ConclusionC-ion RT is a promising treatment option for MMHN.

Teaser

Mucosal melanoma of the head and neck is a rare, radioresistant tumor. This retrospective multicenter study evaluated the effectiveness and safety of carbon-ion radiotherapy for 260 patients with mucosal melanoma of the head and neck. Carbon-ion radiotherapy resulted in good local control and overall survival with acceptable toxicities.


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