Proceedings of the 52nd Annual ASTRO Meeting S479

Conclusions: IMRT appears to be a safe and effective treatment for paranasal sinus tumors.

Author Disclosure: C. Richard, None; A. Turaka, None; T. Li, None; N. Nicolaou, None; E.M. Horwitz, None; M.N. Lango, None;B. Burtness, None; J.A. Ridge, None; S.J. Feigenberg, None.

2617 Mucosal Melanomas of the Head and Neck: A Modern Experience at the University of Miami

K. Saigal, J. D. Palmer, I. Reis, J. N. Sperry

University of Miami, Miami, FL

Purpose/Objective(s): Mucosal melanomas are much rarer than their cutaneous counterparts, and are associated with a poorerprognosis. The upper aerodigestive tract is the most commonly involved site. We report the clinical outcomes of patients withmucosal melanomas of the head and neck region treated with or without radiation therapy (RT).

Materials/Methods: We reviewed the records of 17 patients with mucosal melanomas of the head and neck treated at the Univer-sity of Miami between 1990 and 2007. All pathology slides were reviewed by a dedicated head and neck pathologist. Patients werestaged according to their primary site of disease using the AJCC staging system. Disease-free survival (DFS) and overall survival(OS) were estimated using the Kaplan-Meier method.

Results: Median age was 66 years, with 7 patients being male and 10 female. Sites of disease included the sinonasal tract in 11 (65%)patients and the oral cavity in 6 (35%) patients. Six (35%) patients were clinically staged as having T1, 1 (6%) as T2, 3 (24%) as T3,and 5 (29%) as T4 disease. Fifteen (88%) patients were clinically N0 and 2 (12%) were N2. No patient presented with metastaticdisease. Histology revealed melanoma NOS in 13 (76%) patients and spindle cell melanoma in 4 (24%) patients. Sixteen (94%)patients underwent surgical resection while 1 (6%) received definitive radiation therapy. Eleven (65%) patients received post-operative RT to the involved sites of disease. Only 1 (6%) patient received elective nodal RT. Seven patients (41%) received adjuvantimmunotherapy and 1 (6%) received adjuvant chemotherapy. Median follow-up was 35.2 months (range 5-225) and 61 months inpatients alive at last contact. As the first site of failure: 3 patients recurred locally, 2 regionally and 2 distantly. All 3 patients whorecurred locally had not received RT. Of the 5 locoregional recurrences, 4 were salvaged successfully with no evidence of disease atlast follow-up while 1 patient went on to develop distant metastases. Local control at 2 years was 92.2% and 81% at 5 years. DFScensoring deaths due to unrelated causes was 78.1% at 2 years and 44.5% at 5 years. OS rates were 64.7% at 2 years and 51.5% at5 years. Univariate analysis failed to reveal a prognostic indicator, given the small number of patients and events.

Conclusions: Our data suggest that patients with mucosal melanoma of the head and neck are best treated with surgery followed bypost-operative RT to optimally achieve local control. Elective nodal irradiation may not be indicated in all cases, as few patientsrecurred regionally. Distant control was improved compared to historical data, which is potentially due to increasing use ofsystemic therapies and aggressive salvage treatment at the time of failure. Overall survival in this modern series was greaterthan previous reports.

Author Disclosure: K. Saigal, None; J.D. Palmer, None; I. Reis, None; J.N. Sperry, None.

2618 Outcomes of Oral Tongue Cancer: Does Age Matter?

C. Yip1, J. Wee1, T. Tan1, C. Goh2, T. C. Charn2, H. K. Tan1, K. W. Fong1

1National Cancer Centre, Singapore 120508, Singapore, 2Singapore General Hospital, Singapore 120508, Singapore

Purpose/Objective(s): Retrospective study to examine the outcomes of radically treated oral tongue squamous cell carcinomawith emphasis on young tongues in the National Cancer Centre, Singapore.

Materials/Methods: All patients treated with curative intent from 1998 to 2006 were included. They were classified according totreatment received: surgery alone (Group A), surgery with adjuvant therapy (Group B) and radical radiotherapy (RT) or chemoRT(CRT) (Group C) and stratified according to age groups (#40 and .40 years old). Overall survival (OS) and disease-free survival(DFS) were estimated using Kaplan-Meier method. Fisher exact test was used to analyze the differences between the groups.p\0.05 was deemed significant.

Results: A total of 123 patients were included with 39 (32%), 65 (53%) and 19 (15%) patients in Group A, B and C, respectively.There were 68% males and 32% females. Median age for all patients was 56 years old (range 18-87). Fifteen percent of Group Aand B and 12% of Group C were # 40 years old. Group B and C had more advanced disease with 86% and 95% diagnosed withStage III/IV respectively, compared to 15% in Group A (p\0.05). Concurrent CRT was given to 14% of patients in Group B and79% of Group C. Median follow-up was 29.1 weeks (range 1.2-150.3). Five-year OS and DFS were significantly better in Group A(69%/72%) followed by Group B (41%/47%) and C (16%/10%). Younger patients had better OS (5-year OS for #40 and .40:Group A: 83%/66%; Group B: 75%/36% and Group C: 33%/13%; p 0.012). Univariate analysis revealed T, N, and tumor stage,age, LVI, PNI, extranodal extension (ENE) but not surgical margins, to be significant factors for OS. However, younger patientshad worse DFS than the older cohort in Group A (33% vs. 73%) and C (0% vs. 12%) but this was not statistically significant. Uni-variate analysis showed that T, N and tumor stage as well as ENE were significant factors for DFS but age, PNI, LVI and surgicalmargins were not. Young tongues had less advanced disease with lower rates of LVI, PNI and ENE compared to older patients(p.0.05). In Group A, 50% of the younger cohort (3/6) had local failure compared to 13% (1/8) in Group B and 100% (3/3) inGroup C. Local failure occurred in 30%, 42% and 50% of the older patients in those groups respectively (p.0.05). Rates of distantfailure were higher in the older cohort in all 3 groups (Group A: 0%/12%, Group B: 13%/14% and Group C: 0%/31%) but notsignificantly so.

Conclusions: Survival was better in surgically treated patients but this could be due to their lower initial relapse risk and patientsgiven radical RT typically had more advanced disease. However, the survival and control rates in the adjuvant and radical RTgroups remained dismal, hence concurrent chemoRT should be considered. Lastly, younger patients did not appear to have worsepathological features or clinical outcomes compared to the older population.

Author Disclosure: C. Yip, None; J. Wee, None; T. Tan, None; C. Goh, None; T.C. Charn, None; H.K. Tan, None; K.W. Fong,None.