Mucosal Malignant Melanoma of the Head and Neck Treated by Carbon Ion Radiotherapy
Received 31 March 2008; received in revised form 10 July 2008; accepted 24 July 2008. published online 28 November 2008.
Purpose
To evaluate the efficacy of carbon ion radiotherapy for mucosal malignant melanoma of the head and neck.
Methods and Materials
Between 1994 and 2004, 72 patients with mucosal malignant melanoma of the head and neck were treated with carbon ion beams in three prospective studies. Total dose ranged from 52.8 GyE to 64 GyE given in 16 fixed fractions over 4 weeks. Clinical parameters including gender, age, Karnofsky index, tumor site, tumor volume, tumor status, total dose, fraction size, and treatment time were evaluated in relation to local control and overall survival.
Results
The median follow-up period was 49.2 months (range, 16.8–108.5 months). Treatment toxicity was within acceptable limits, and no patients showed Grade 3 or higher toxicity in the late phase. The 5-year local control rate was 84.1%. In relation to local control, there were no significant differences in any parameters evaluated. The 5-year overall and cause-specific survival rates were 27.0% and 39.6%, respectively. For overall survival, however, tumor volume (≥100 mL) was found to be the most significant prognostic parameter. Of the patients who developed distant metastasis, 85% were free from local recurrence.
Conclusion
Carbon ion radiotherapy is a safe and effective treatment for mucosal malignant melanoma of the head and neck in terms of high local control and acceptable toxicities. Overall survival rate was better than in those treated with conventional radiotherapy and was comparable to that with surgery.
∗National Institute of Radiological Sciences, Research Center Hospital for Charged Particle Therapy, Chiba, Japan
†Division of Otorhinolaryngology, Graduate School of Medicine and School of Medicine, Chiba University, Chiba, Japan
Reprint requests to: Takeshi Yanagi, M.D., Ph.D., Department of Radiation Medicine, Research Center of Charged Particle, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage-ku, Chiba City, Chiba Prefecture 263-8555, Japan. Tel: (+81) 43-206-3306; Fax: (+81) 43-256-6506
ABSTRACT