부산대학교 도서관

Mucosal malignant melanoma accounts for about 10% of all cases of malignant melanoma, and in the head and neck region, these tumors most frequently arise in the sinonasal cavities. Radical resection + postoperative radiotherapy is considered as the standard treatment, but distant metastases are common and the prognosis is poor. In recent years, the efficacy of proton beam therapy and immune checkpoint inhibitor (ICI) therapy, as novel treatment options, has been reported. We reviewed the data of 14 cases of sinonasal mucosal malignant melanoma who received multidisciplinary treatment at Nagoya City University Hospital between January 2014 and April 2021. The median age of the patients, consisting of 6 men and 8 women, was 76 years. As the initial treatment, surgery was performed in 3 cases, proton beam therapy in 9 cases, and ICI therapy in 2 cases (distant metastases). The response rate to proton beam therapy was 55.6%. Including cases that developed recurrence, 12 cases received anti-PD-1 therapy, 1 received anti-CTLA4 therapy, and 3 received anti-PD-1 + anti-CTLA4 therapy. The median survival duration after ICI treatment was 17 months (range: 3-58 months). Although patients with recurrence in poor general condition did not show good responses to ICI therapy, even patients who were 80 years old or older who were in good general condition could receive ICI therapy for a long period. In the future, it is necessary to develop individualized treatment strategies that would take into account the timing of ICI therapy.