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Int J Radiat Oncol Biol Phys. 2011 Sep 1;81(1):135-9. doi: 10.1016/j.ijrobp.2010.04.071. Epub 2010 Oct 13.

Proton beam therapy as a nonsurgical approach to mucosal melanoma of the head and neck: a pilot study.

Author information

1
Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. szenda@east.ncc.go.jp

Abstract

PURPOSE:

The aim of this pilot study was to assess the clinical benefit of proton beam therapy for mucosal melanoma of the head and neck.

METHODS AND MATERIALS:

Patients with mucosal melanoma of the head and neck with histologically confirmed malignant melanoma and N0 and M0 disease were enrolled. Proton therapy was delivered three times per week with a planned total dose of 60 Gy equivalents (GyE) in 15 fractions.

RESULTS:

Fourteen consecutive patients were enrolled from January 2004 through February 2008. Patient characteristics were as follows: median age 73 years old (range, 56 to 79 years); male/female ratio, 7/7; and T stage 1/2/3/4, 3/2/0/9. All patients were able to receive the full dose of proton therapy. The most common acute toxicities were mucositis (grade 3, 21%) and mild dermatitis (grade 3, 0%). As for late toxicity, 2 patients had a unilateral decrease in visual acuity, although blindness did not occur. No treatment-related deaths occurred throughout the study. Initial local control rate was 85.7%, and, with a median follow-up period of 36.7 months, median progression-free survival was 25.1 months, and 3-year overall survival rates were 58.0%. The most frequent site of first failure was cervical lymph nodes (6 patients), followed by local failure in 1 patient and lung metastases in 1 patient. On follow-up, 5 patients died of disease, 4 died due to cachexia caused by distant metastases, and 1 patient by carotid artery perforation cause by lymph nodes metastases.

CONCLUSIONS:

Proton beam radiotherapy showed promising local control benefits and would benefit from ongoing clinical study.

PMID:
20950948
DOI:
10.1016/j.ijrobp.2010.04.071
[Indexed for MEDLINE]

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