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. 2025 Feb;8(2):e70111.
doi: 10.1002/cnr2.70111.

Adjuvant Proton Beam Radiation Therapy for Sinonasal Mucosal Melanoma

Jamie S K Takayesu  1 , Upendra Parvathaneni  1   2 , George E Laramore  1 , Neil Panjwani  1 , Jennifer Sillings  1 , Neal D Futran  3 , Ian M Humphreys  3 , Aria Jafari  3 , Waleed M Abuzeid  3 , Brittany Barber  3 , Emily Marchiano  3 , Sylvia M Lee  4 , John A Thompson  4 , Evan Hall  4 , Shailender Bhatia  4 , Cristina P Rodriguez  4 , Jay J Liao  1
Affiliations

Adjuvant Proton Beam Radiation Therapy for Sinonasal Mucosal Melanoma

Jamie S K Takayesu et al. Cancer Rep (Hoboken). 2025 Feb.

Abstract

Background: Head and neck mucosal melanoma (HNMM) is rare and carries a poor prognosis with high rates of disease progression. There is little data regarding the use of adjuvant proton radiation therapy in the management of sinonasal HNMM.

Aims: We performed a retrospective review of patients with nonmetastatic sinonasal HNMM treated with adjuvant proton radiation from 2012 to 2022 at a single academic institution. Kaplan-Meier estimates were used for survival analyses.

Methods and results: Eight patients with sinonasal HNMM were treated with surgery and adjuvant proton radiation, and six received systemic therapy. Median follow-up was 15 months (range: 3-68 months). Only one local failure was observed, and two patients developed distant metastases. Kaplan-Meier 1-year results were as follows: local control 88%, distant metastasis-free survival 75%, and overall survival 88%. No Grade 3 or higher late toxicities were observed.

Conclusion: Surgical resection and adjuvant proton radiation provided early favorable local control and toxicity profiles in our cohort of patients with sinonasal HNMM. Further multi-institutional work is needed to study this rare malignancy.

Keywords: immunotherapy; mucosal melanoma; protons; radiation therapy; sinonasal cancer.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Representative radiation plan of a patient who presented with T3N0 sinonasal HNMM arising from and confined to the nasopharynx managed with an endoscopic resection with gross total resection but close surgical margins. The patient then received adjuvant proton radiation 66 GyE in 33 fractions to the nasopharynx. Planning target volume is shaded in red. Representative axial (a), coronal (b), and sagittal (c) slices are provided.
FIGURE 2
FIGURE 2
Kaplan–Meier survival curves for overall survival (OS), progression‐free survival (PFS), local control (LC), and distant metastasis‐free survival (DMFS).
See this image and copyright information in PMC

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