Robotic stereotactic body radiotherapy in the treatment of sinonasal mucosal melanoma: report of four cases.

Background. Sinonasal mucosal melanoma (SNMM) is a rare entity originating from melanocytes of the sinonasal mucosa. Postoperative radiotherapy is recommended in all cases to increase local control. However, external radiotherapy is rarely used as a definitive treatment modality. In this report, we present 4 cases of SNMM treated with CyberKnife (Accuray, Sunnyvale, CA). Methods. All patients were immobilized with a thermoplastic mask. A planning CT scan with 1-mm thickness was obtained, and these images were fused with MRI for the contouring procedure. Multiplan (Accuray) inverse planning software was used for treatment planning. Robotic stereotactic body radiotherapy (SBRT) was delivered with CyberKnife. Results. Median follow-up was 26 months. Three patients had complete response to CyberKnife, and 1 patient had partial response. Conclusion. Robotic SBRT seems to be an appealing treatment option for local control. Effective systemic treatment is required to prevent distant metastases. (C) 2011 Wiley Periodicals, Inc. Head Neck 35: E69-E73, 2013