Curative carbon ion radiotherapy in a head and neck mucosal melanoma series: Facing the future within multidisciplinarity.

Carbon Ion Radiotherapy Combined Modality Therapy Head and Neck Cancer Immunotherapy Mucosal Melanoma Multidisciplinary Care Team

Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
11 Nov 2023
Historique:
received: 26 04 2023
revised: 05 11 2023
accepted: 10 11 2023
pubmed: 14 11 2023
medline: 14 11 2023
entrez: 13 11 2023
Statut: aheadofprint

Résumé

To evaluate efficacy and toxicity of carbon ion radiotherapy (CIRT) in locally advanced head and neck mucosal melanoma (HNMM) patients treated at our Institute. Between June 2013 and June 2020, 40 HNMM patients were treated with CIRT. Prescription dose was 65.6-68.8 Gy relative biological effectiveness [RBE] in 16 fractions. Twelve (30%) patients received only biopsy, 28 (70%) surgical resection before CIRT. Immunotherapy was administered before and/or after CIRT in 45% of patients, mainly for distant progression (89%). Median follow-up was 18 months. 2-year Local Relapse Free Survival (LRFS), Overall Survival (OS), Progression Free Survival (PFS) and Distant Metastasis Free Survival (DMFS) were 84.5%, 58.6%, 33.2% and 37.3%, respectively. At univariate analysis, LRFS was significantly better for non-recurrent status, < 2 surgeries before CIRT and treatment started < 9 months from the initial diagnosis, with no significant differences for operated versus unresected patients. After relapse, immunotherapy provided longer median OS (17 months vs 3.6, p-value<0.001). Late toxicity ≥ G3 (graded with CTCAE 5.0 scale) was reported in 10% of patients. CIRT in advanced HNMM patients is safe and locally effective. Prospective trials are warranted to assess the role of targeted/immune- systemic therapy to improve OS.

Identifiants

DOI: 10.1016/j.radonc.2023.110003 PMID: 37956889
pubmed: 37956889
pii: S0167-8140(23)09310-6
doi: 10.1016/j.radonc.2023.110003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110003

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Sara Ronchi, Alessandro Cicchetti, Maria Bonora, Rossana Ingargiola, Anna Maria Camarda, Stefania Russo,Sara Imparato, Paolo Castelnuovo, Ernesto Pasquini, Piero Nicolai, Mohssen Ansarin, Marco Benazzo, EsterOrlandi and Barbara Vischioni declare no conflict of interest. Michele Del Vecchio reports research funding to their institution for clinical studies and research outside the submitted work from MSD, and as a consultant or advisor from BMS, MSD, Novartis, Pierre Fabre, Immunocore.

Auteurs

Sara Ronchi (S)

Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. Electronic address: sara.ronchi@cnao.it.

Alessandro Cicchetti (A)

Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy.

Maria Bonora (M)

Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Rossana Ingargiola (R)

Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Anna Maria Camarda (AM)

Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Stefania Russo (S)

Medical Physics Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Sara Imparato (S)

Radiology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Paolo Castelnuovo (P)

Department of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.

Ernesto Pasquini (E)

Azienda USL di Bologna, ENT Department, Bellaria Hospital, Bologna, Italy.

Piero Nicolai (P)

Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua - "Azienda Ospedaliera di Padova", Padua, Italy.

Mohssen Ansarin (M)

Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Michele Del Vecchio (M)

Unit of Melanoma Medical Oncology, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian 1, Milan 20133, Italy.

Marco Benazzo (M)

Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.

Ester Orlandi (E)

Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Barbara Vischioni (B)

Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.

Classifications MeSH