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Fast neutron radiotherapy for primary mucosal melanomas of the head and neck
Author(s) -
Liao Jay J.,
Parvathaneni Upendra,
Laramore George E.,
Thompson John A.,
Bhatia Shailender,
Futran Neal D.,
Bhrany Amit D.,
Hawes Stephen E.,
Ladra Matthew
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23428
Subject(s) - medicine , debulking , radiation therapy , head and neck , mucosal melanoma , radioresistance , surgery , radiology , cancer , ovarian cancer
Abstract Background Primary head and neck mucosal melanomas (HNMMs) are rare tumors managed with surgery and/or radiotherapy and associated with poor outcomes. Given their radioresistance, high linear energy transfer radiotherapy with neutrons may improve local control. Methods We conducted a retrospective review of 14 patients with HNMM treated with neutrons at the University of Washington from 1990 to 2012. Five patients had T3 disease, 9 had T4 disease, 3 had regional nodal disease, and 4 had distant metastases at diagnosis. Primary sites were sinonasal ( n =10), lip ( n =2), and palate ( n =2). Ten patients had initial surgical resection/debulking. Results Nine patients had gross residual disease, 6 had complete response, and 3 had partial response. Local control was achieved in 79% until death or last follow‐up, and 50% developed distant metastases. Kaplan–Meier 5‐year local control was 66% and overall survival was 21%. Conclusion High rates of locoregional control were achieved with neutrons, despite the presence of gross disease. Survival was limited by early distant metastases. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1162–1167, 2014