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KUANetal.

TABLE XXIV.D.5 Evidence surrounding the role of radiation therapy in sinonasal mucosal melanoma.

Clinical endpoints

Study Grant

Year LOE Study design Study groups

Conclusion

1. SR has a lower risk of death compared to surgery alone 2. SR has a reduced risk of local recurrence versus surgery alone 3. SR does not influence distant metastasis

1. OS 2. Local

2021

1

Systematic review

22 studies; Head and neck mucosal melanoma (site not specified, n = 2489)

Freemantle et al. 1573

recurrence

3. Distant

metastasis

Zenda et al. 1586

2016 3

Prospective cohort

SNMM patients at a single institution treated with proton beam RT only (60Gy in15 fractions) ( n = 32) SNMM patients across 11 institutions (four United States, seven Europe) ( n = 505) SNMM patients at a single institution ( n = 31)

1. Local control rate 2. OS

1. 1-year local control = 75% 2. 3-year OS = 46.1%

1. OS 2. DFS

1. Surgery and adjuvant RT associated with improved OS compared to surgery alone 2. RT conferred no significant impact on DFS Stage, primary site, smoking status, margin status, time to treatment, and RT not associated with OS, LRC, or distant control RT not associated with improved 2-yearOS 1. Adjuvant RT associated with improved local control 2. No difference in distant metastasis between surgery versus surgery with RT No difference in OS between surgery alone and surgery with adjuvant RT RT is associated with improved local control but not survival benefit RT decreased local recurrence, no impact on OS 1. Adjuvant RT associated with improved local control 2. Adjuvant RT did not affect OS 1. 5-year local control rate 13% for RTonly ( n = 21) versus 30% for surgery with RT 2. Median survival for surgery

Lechner

2022 3

Retrospective cohort

et al. 1564

Manton et al. 1576 2019 4

Retrospective case series

1. OS 2. LRC 3. Distant control 1. OS 2. Factors

Oliver et al. 1503

All head and neck

2019 4

Retrospective database study (NCDB)

mucosal melanoma patients in NCDB 2004–2015 ( n = 1373)

associated with improved 2-yearOS

Caspers et al. 364

2018 4

Retrospective case series

SNMM patients at a single institution ( n = 51)

1. OS 2. DSS 3. Local

recurrence

4. Distant

metastasis

Konuthula et al. 1574

All SNMM patients in NCDB 2004–2010

OS

2016 4

Retrospective database study (NCDB) Retrospective case series

Samstein et al. 1579

2016 4

SNMM patients at a single institution ( n = 78) SNMM patients from 15 hospitals in South Korea ( n = 155) SNMM patients at a single institution ( n = 58)

1. OS 2. DSS

Wonet al. 269

1. OS 2. Recurrence rate

2015 4

Retrospective case series

Morenoand Hanna 1506

2010 4

Retrospective case series

1. OS 2. Local

recurrence

Bachar et al. 400

1. DFS 2. Local,

2008 4

Retrospective case series

Head and neck

patients at a single institution ( n , SNMM = 49)

regional, distant recurrence

3. Median survival alone, RT alone, and combined therapy: 31, 28, and 21 months, respectively Abbreviations: DFS, disease-free survival; DSS, disease-specific survival; NCDB, National Cancer DataBase; OS, overall survival; RT, radiation therapy; SEER, Surveillance, Epidemiology, and End Results; SNMM, sinonasal mucosal melanoma; SR, surgery + RT.