Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy

Head & Neck ◽  
2017 ◽  
Vol 40 (1) ◽  
pp. 86-93 ◽  
Author(s):  
Jules Lansu ◽  
Willem Martin Klop ◽  
Wilma Heemsbergen ◽  
Arash Navran ◽  
Abrahim Al-Mamgani ◽  
...  
2018 ◽  
Vol 132 (12) ◽  
pp. 1051-1060
Author(s):  
R Hu ◽  
B-B Yang

AbstractObjectiveSinonasal malignant melanoma is a relatively rare malignancy with poor prognosis, and effective treatments remain elusive. This analysis aimed to explore whether post-operative radiotherapy conferred any survival advantages in patients with this disease when compared with surgery alone.MethodsPublished studies were identified by searching four electronic databases. The endpoints evaluated were: rates of overall survival, disease-free survival and local control.ResultsTwenty-eight studies including 1392 patients were identified. The results indicated that post-operative radiotherapy led to a significantly better three-year overall survival rate (p= 0.02), and suggested a borderline significant benefit for five-year overall survival (p= 0.05), when compared with surgery alone. However, no statistical advantage was found for disease-free survival, local control or one-year overall survival.ConclusionThis meta-analysis indicated that adjuvant radiotherapy prolonged survival, but showed no benefit for disease-free survival or local control.


1997 ◽  
Vol 111 (4) ◽  
pp. 376-378 ◽  
Author(s):  
Samuel M. Jayaraj ◽  
Jonathan D. Hern ◽  
George Mochloulis ◽  
Graham C. Porter

AbstractSinonasal malignant melanoma is rare and usually occurs in the nasal cavity. Presentation is often varied and occurs late in the natural history of the disease, resulting in a poor prognosis. A case is reported of a patient with malignant melanoma arising from the frontal sinus who presented with a forehead swelling and progressive confusion. A review of the literature on malignant melanoma in the nasal cavity and paranasal sinuses regarding its presentation, site of origin and principles of management is discussed.


2017 ◽  
Vol 34 (3) ◽  
pp. 255-262 ◽  
Author(s):  
Sercan Göde ◽  
Göksel Turhal ◽  
Ceyda Tarhan ◽  
Banu Yaman ◽  
Gülşen Kandiloğlu ◽  
...  

Neurosurgery ◽  
2009 ◽  
Vol 64 (suppl_2) ◽  
pp. A26-A32 ◽  
Author(s):  
Wendy Hara ◽  
Phuoc Tran ◽  
Gordon Li ◽  
Zheng Su ◽  
Putipun Puataweepong ◽  
...  

Abstract OBJECTIVE To evaluate the efficacy of CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) for patients with brain metastases of malignant melanoma and renal cell carcinoma. METHODS We conducted a retrospective review of all patients treated by image-guided radiosurgery at our institution between March 1999 and December 2005. Sixty-two patients with 145 brain metastases of renal cell carcinoma or melanoma were identified. RESULTS The median follow-up period was 10.5 months. Forty-four patients had malignant melanoma, and 18 patients had renal cell carcinoma. The median age was 57 years, and patients were classified as recursive partitioning analysis Class 1 (6 patients), 2 (52 patients) or 3 (4 patients). Thirty-three patients had been treated systemically with either chemotherapy or immunotherapy, and 33 patients were taking corticosteroids at the time of treatment. The mean tumor volume was 1.47 mL (range, 0.02–35.7 mL), and the mean prescribed dose was 20 Gy (range, 14–24 Gy). The median survival after SRS was 8.3 months. Actuarial survival at 6 and 12 months was 57 and 37%, respectively. On multivariate analysis, Karnofsky Performance Scale score (P < 0.01) and previous immunotherapy/clinical trial (P = 0.01) significantly affected overall survival. One-year intracranial progression-free survival was 38%, and local control was 87%. Intracranial control was impacted by whole-brain radiotherapy (P = 0.01), previous chemotherapy (P = 0.01), and control of the primary at the time of SRS (P = 0.02). Surgical resection had no effect on intracranial or local control. Radiographic evidence of radiation necrosis developed in 4 patients (6%). CONCLUSION CyberKnife radiosurgery provided excellent local control with acceptable toxicity in patients with melanoma or renal cell brain metastases. Initial SRS alone appeared to be a reasonable option, as survival was dictated by systemic disease.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3032-3032 ◽  
Author(s):  
Sana Shoukat ◽  
David Mitchell Marcus ◽  
Monica Rizzo ◽  
David H. Lawson ◽  
Yuan Liu ◽  
...  

3032 Background: SRS with Ipi for brain metastases from malignant melanoma has been explored for overall survival (OS) (Knisely JP, Yu JB, Flanigan J, et al. Radiosurgery for melanoma brain metastases in the ipilimumab era and the possibility of longer survival. J Neurosurg. 2012;117:227-33). We present the first retrospective analysis to determine if this combination is safe and improves OS, while accounting for lactate dehydrogenase (LDH). Methods: Patients with melanoma brain metastases who underwent SRS between 1998-2010 (n=124) were compared with those who additionally received Ipi (n=11). The primary endpoint was median OS from time of SRS, calculated using Kaplan-Meier method. Cox proportional hazard model was carried out for univariate and multivariable survival analysis. The secondary endpoints were local control at initial site of SRS, anywhere intra-cranial failure, need for repeat SRS, and toxicity. Results: Median OS for the entire cohort was 6.9 months. Patients in the Ipi group had an improved median OS of 28.3 months vs. 6.8 months in the non-Ipi group (p = 0.013). No difference was noted in local control, anywhere intracranial failures, toxicity (radionecrosis, hemorrhage, patient reported memory deficits), or need for repeated SRS. MVA (Table) showed that Ipi independently predicted for improved OS even when taking into account LDH and ECOG performance status. The only confounding factor within the Ipi group was younger age of the Ipi cohort (43 vs. 55 yrs, p = 0.006). Conclusions: Use of SRS with Ipi appears to be safe and associated with an impressive increase in median OS in patients with brain metastases from malignant melanoma; this combination should be further investigated. [Table: see text]


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