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Background  The significance of definitive radiotherapy for sinonasal mucosal melanoma (SMM) is sill controvertial.  T his study was to evaluate the role of high-dose proton beam therapy (PBT) in patients with SMM.    Methods  The cases of 20 patients with SMM localized to the primary site who were treated by PBT between 2006 and 2012 were retrospectively analyzed. The patterns of overall survival and morbidity were assessed.    Results  The median follow-up time was 35 months (range, 6–77 months). The 5-year overall and disease-free survival rates were 51% and 38%, respectively. Four patients showed local failure, 2 showed regrowth of the primary tumor, and 2 showed new sinonasal tumors beyond the primary site. The 5-year local control rate after PBT was 62%. Nodal and distant failure was seen in 7 patients. Three grade 4 late toxicities were observed in tumor-involved optic nerve.    Conclusion  Our findings suggested that high-dose PBT is an effective local treatment that is less invasive than surgery but with comparable outcomes.

High-dose proton beam therapy for sinonasal mucosal malignant melanoma