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Fast neutron radiotherapy for primary mucosal melanomas of the head and neck
Jay J Liao1, Upendra Parvathaneni, George E Laramore
1University of Washington, Department of Radiation Oncology, Seattle, Washington.
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.
