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

Abstract

Background: The purpose of this study was to analyze the effect of fractionationschedule on local control in postoperative radiotherapy (RT) for sinonasal malignantmelanoma.Methods: Sixty-three patients who were treated with surgery and postoperative RTin 4 accredited head and neck cancer centers in the Netherlands between 1998 and2013 were retrospectively studied. Outcomes with conventional fractionation (2-2.4Gy per fraction; n 5 27) were compared to hypofractionation (4-6 Gy per fraction;n 5 36). The primary endpoint was local control and the secondary endpoint wastoxicity.Results: Comparable local control rates were found after 2 and 5 years (63% vs 64%and 47% vs 53%; P 5 .73 for, respectively, conventional fractionation vs hypofractio-nation). Local recurrences were predominantly present ipsilateral (92%) and withinthe irradiated volume (88%). Late toxicity grade 3 was observed in 2 of 63 patients,1 patient in both groups.Conclusion: Radiotherapy fractionation schedule did not influence the local controlrate or the incidence of late toxicity in patients treated with surgery and RT for sino-nasal malignant melanoma in this retrospective analysis. Due to this retrospectivenature and the limited number of patients, strong recommendations cannot be made.Expected toxicity, patient convenience, and workload may be taken into account forthe choice of fractionation schedule until conclusive evidence becomes available.