scholarly journals Mucosal Melanomas of the Head and Neck: The Role of Postoperative Radiation Therapy

ISRN Oncology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kunal Saigal ◽  
Donald T. Weed ◽  
Isildinha M. Reis ◽  
Arnold M. Markoe ◽  
Aaron H. Wolfson ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Neck Region ◽  
Distant Metastases ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Head And Neck Region ◽  
Definitive Surgery ◽  
The University

Objectives. Mucosal melanomas are rarer than their cutaneous counterparts and are associated with a poorer prognosis. We report the clinical outcomes of patients with mucosal melanomas of the head and neck region generally treated with definitive surgery followed by postoperative radiation therapy (RT). Methods. We reviewed the records of 17 patients treated at the University of Miami in 1990–2007. Patients generally received conventionally fractionated RT regimens to the postoperative bed. Elective nodal RT was not routinely delivered. Eight patients received adjuvant chemotherapy or immunotherapy. Results. Median followup was 35.2 months (range 5–225). As the first site of failure: 3 patients recurred locally, 2 regionally and 2 distantly. All 3 patients who recurred locally had not received RT. Of the 5 locoregional recurrences, 4 were salvaged successfully with multimodality therapy with no evidence of disease at last followup. Overall survival was 64.7% at 2 years and 51.5% at 5 years. Conclusions. Patients with mucosal melanoma of the head and neck are best treated with surgery to achieve negative margins, followed by postoperative RT to optimize local control. Elective nodal irradiation may not be indicated in all cases, as regional failures were not predominant. Distant metastases were fewer when compared to historical data, potentially due to advancements in adjuvant therapies as well as aggressive multi-modality salvage at time of failure.

Randomized Preoperative and Postoperative Radiation Therapy for Patients with Carcinoma of the Head and Neck: Preliminary Report

1980 ◽  
Vol 90 (6) ◽  
pp. 930-945 ◽  
Author(s):  
James B. Snow ◽  
Richard D. Gelber ◽  
Simon Kramer ◽  
Lawrence W. Davis ◽  
Victor A. Marcial ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Preliminary Report ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy

scholarly journals Effect of time to initiation of postoperative radiation therapy on survival in surgically managed head and neck cancer

Cancer ◽  
2017 ◽  
Vol 123 (24) ◽  
pp. 4841-4850 ◽  
Author(s):  
Evan M. Graboyes ◽  
Elizabeth Garrett‐Mayer ◽  
Mark A. Ellis ◽  
Anand K. Sharma ◽  
Amy E. Wahlquist ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Time To Initiation

Indications and Parameters Around Postoperative Radiation Therapy for Lung Cancer

2022 ◽  
Author(s):  
Antonin Levy ◽  
Olaf Mercier ◽  
Cécile Le Péchoux
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Small Cell ◽  
Postoperative Radiation ◽  
Small Cell Lung ◽  
Postoperative Radiation Therapy

Patients with locally advanced resected non–small-cell lung cancer present a high risk of relapse. Although adjuvant platinum–based chemotherapy has become the standard of care, the role of postoperative radiation therapy (PORT) has been controversial for years. In patients with incomplete resection, PORT should be proposed, on the basis of a strong consensus, despite the absence of randomized evidence. In patients with completely resected (R0) non–small-cell lung cancer, a meta-analysis showed poorer outcomes after PORT in the absence of mediastinal involvement (pN0 and pN1). In patients with pN2, the role of PORT was less clear and required further research. The meta-analysis included trials using older radiation techniques and poorer quality of surgery according to today's standards, and selection of patients was not positron emission tomography–based. Newer retrospective and nonrandomized studies and subgroup analyses of randomized trials evaluating adjuvant chemotherapy suggested a survival benefit of PORT in patients with pN2 R0. Two recent randomized trials (Lung ART and PORT-C) evaluating conformal PORT versus no PORT retrieved no disease-free survival advantage for stage IIIA-N2 patients, even if mediastinal relapse was significantly decreased with PORT. PORT had no effect on survival, possibly given the high rate of distant relapse and risk of additional cardiopulmonary toxicity. Ongoing and future analyses are planned in Lung ART to identify patients for whom PORT could be recommended. Incorporation of newer systemic treatments (immune checkpoint inhibitors or targeted therapy in oncogene-addicted patients) is underway in the neoadjuvant and/or adjuvant setting. Better identification of patients at a high risk of disease recurrence, with analysis of circulating tumor DNA, on the basis of the detection of postsurgical minimal (or molecular) residual disease is warranted in future studies.

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