Mélanomes muqueux de la tête et du cou : état actuel des pratiques et controverses

Troussier, I.; Baglin, Anne–Catherine; Marcy, Pierre-Yves; Even, Caroline; Moya‐Plana, Antoine; Krengli, Marco; Thariat, Juliette

doi:10.1016/j.bulcan.2015.04.013

Cited by 18 publications

(6 citation statements)

References 65 publications

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“…Of the patients with 2 years with no evidence of disease (n = 20), only 1 patient was still feeding-tube dependent and 2 patients had grade 3 xerostomia. Concerning hypofractionated postoperative radiotherapy in head and neck cancers (reirradiation excepted), its use has already been reported in mucosal melanoma [34][35][36]. Wu et al [36] reported in 2010 the outcomes of 27 patients (10 of them treated with 5 × 6 Gy over 2 weeks).…”

Section: Discussionmentioning

confidence: 99%

A multicenter prospective phase II study of postoperative hypofractionated stereotactic body radiotherapy (SBRT) in the treatment of early-stage oropharyngeal and oral cavity cancers with high risk margins: the STEREO POSTOP GORTEC 2017-03 trial

et al. 2020

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Background: Primary surgery is usually the mainstay treatment in early-stage oropharyngeal and oral cavity cancer. Typically, neck surgery is performed. Negative tumor margins are recommended (> 5 mm). If feasible, re-resection of any positive margin is preferred. Otherwise, postoperative radiotherapy is required. Adjuvant postoperative radiotherapy can be limited to the primary site for patients with pT1-T2 tumors and negative neck exploration. Currently, both fractionated external beam radiotherapy and brachytherapy can have a role in the postoperative management of early-stage oropharyngeal and oral cavity cancer with high risk margins. Another possible alternative could be postoperative stereotactic body radiotherapy (SBRT). The aim of this study is to evaluate postoperative SBRT in the treatment of early-stage oropharyngeal and oral cavity cancer with high risk margins. Methods: The STEREO POSTOP study is a national, open-label, non-randomized phase II trial within the GORTEC network. Patients with early-stage oropharyngeal and oral cavity cancers with high risk margins indicating the need for postoperative radiation are eligible for enrollment. SBRT consists of a total dose of 36 Gy in 6 fractions over 2 weeks. The primary endpoint is severe late toxicity defined as 2-year toxicity of grade ≥ 3 according to CTCAE V4.03 classification. The secondary endpoints include acute toxicity (≤ 3 months), local and locoregional control, diseasefree and overall survival, quality of life of patients, nutritional impact and predictive factors of toxicity. The experimental design chosen is a one-step Fleming plan design without interim analysis as the primary endpoint will be evaluated at a 2-year follow-up. Ninety patients will be recruited. The study was started in January 2018 with

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Section: Discussionmentioning

confidence: 99%

A multicenter prospective phase II study of postoperative hypofractionated stereotactic body radiotherapy (SBRT) in the treatment of early-stage oropharyngeal and oral cavity cancers with high risk margins: the STEREO POSTOP GORTEC 2017-03 trial

et al. 2020

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“…The vast majority of SNMM patients receiving primary radiation therapy alone have advanced, inoperable tumors or are ineligible for surgery due to, e.g., their performance status or comorbidities; this group also includes patients who have not given their consent to surgical treatment. 4,5,7,14,16,17,[19][20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Four of our patients had inoperable tumors while two refused surgery. As in our group, most studies report a similar incidence between male and female SNMM patients 1,4,5,30,32 ; some researchers observe a slight male predominance.…”

Section: Our Materialsmentioning

confidence: 99%

“…2,3,[7][8][9][10][11] HNMM is characterized by relatively frequent local recurrences (26-85%) and distant metastases (18-68%). 2,9,[11][12][13][14] Primary surgery, aimed at removing the tumor within the margin of healthy tissue, is the treatment of choice for such patients. [4][5][6][7]9,13,15 Unfortunately, radical procedures are often difficult, mainly due to the dissemination of HNMM, its frequent multi-focal character and complex anatomy in the surgical field associated with the close proximity of numerous critical structures with important functions.…”

Section: Introductionmentioning

confidence: 99%

“…4,5,10,13,16 If the procedure is not microor macroscopically radical, the widely accepted approach is the use of postoperative radiotherapy. 4,5,7,14,17,18 In patients who are not eligible for primary surgical treatment, primary definitive or palliative radiotherapy is applied. 4,5,14,[17][18][19][20][21][22] The objective of our study was to present the outcomes of SNMM patients treated with primary radiotherapy alone, and analyse current views on the role of external radiotherapy as a definitive treatment modality for HNMM.…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy alone as a method of treatment for sinonasal mucosal melanoma: A report based on six cases and a review of current opinion

Sas-Korczyńska

Reinfuss

Mituś-Kenig

et al. 2018

Reports of Practical Oncology & Radiotherapy

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“…Furthermore, due to high incidence of local recurrence and distant metastasis, MMHN is well known for poor prognosis with the 5-year overall survival (OS) ranging from 15% to 35% [ 5 ]. Although definitive guidelines for optimal management have not been established, proper surgical resection with a clear margin is accepted as the mainstay of treatment in operable MMHN [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Role of the Surgical Approach and Adjuvant Therapy in Operable Mucosal Melanoma of the Head and Neck

Lee

Baek

Choi

et al. 2017

Clin Exp Otorhinolaryngol

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ObjectivesThe aim of this study was to investigate the prognostic impact of the surgical approach and adjuvant treatment in operable malignant melanoma of head and neck (MMHN).MethodsRetrospective reviews of 31 patients who underwent surgery-based treatment with curative intent, either by the endoscopic or external approach, for MMHN were performed to analyze recurrence patterns, salvage modalities, and oncological outcomes (disease-specific survival and disease-free survival).ResultsOverall recurrence rate was 61% (19/31). In stage III patients (n=24), 50% (12/24) developed recurrences with a median recurrence-free period of 6.0 months, and 30% (4/12) of them was successfully salvaged by reoperation with adjuvant radiotherapy. On the contrary, all stage IVA patients (n=7) developed recurrences with a median recurrence-free period of 4.4 months. Distant metastasis was the most common pattern of failure and no patients were salvaged. Among variables, age and T classification, not the surgical approach, were significant prognosticators for disease-free survival and disease-specific survival. Adjuvant radiotherapy was associated with a lower rate of local failure, compared to surgery alone (hazard ratio, 0.02; 95% confidence interval, 0.06 to 0.75; P=0.02). However, adjuvant systemic therapy was not effective in reducing the risk of failures for any pattern.ConclusionOur data suggested that meticulous surgical resection, either by the endoscopic or external approach, with adjuvant radiotherapy increases the local control rate in MMHN.

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Mélanomes muqueux de la tête et du cou : état actuel des pratiques et controverses

Cited by 18 publications

References 65 publications

A multicenter prospective phase II study of postoperative hypofractionated stereotactic body radiotherapy (SBRT) in the treatment of early-stage oropharyngeal and oral cavity cancers with high risk margins: the STEREO POSTOP GORTEC 2017-03 trial

A multicenter prospective phase II study of postoperative hypofractionated stereotactic body radiotherapy (SBRT) in the treatment of early-stage oropharyngeal and oral cavity cancers with high risk margins: the STEREO POSTOP GORTEC 2017-03 trial

Radiotherapy alone as a method of treatment for sinonasal mucosal melanoma: A report based on six cases and a review of current opinion

The Prognostic Role of the Surgical Approach and Adjuvant Therapy in Operable Mucosal Melanoma of the Head and Neck

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