Grant-Freemantle Marc C, Lane O'Neill Billy, Clover Anthony James P
School of Medicine, University College Cork, Cork, Ireland.
Department of Plastic Surgery, Cork University Hospital, Cork, Ireland.
Head Neck. 2021 Jan;43(1):323-333. doi: 10.1002/hed.26470. Epub 2020 Sep 14.
Mucosal melanoma (MM) is a rare condition with a poor prognosis. Surgery is the corner stone of treatment, however, radiotherapy has been commonly employed as a treatment strategy and recent studies suggesting that survival outcomes may be improving are emerging.
A systematic review and meta-analysis comparing risk ratios of radiotherapy and surgery and radiotherapy (SRT) with surgery for 5-year overall survival, local recurrence and distant metastasis in head and neck mucosal melanoma (HNMM).
SRT has a lower risk of death compared to surgery [RR 0.93 [95% CI = 0.87, 0.98] (P = .01)] and a reduced risk of local recurrence [RR 0.63 [95% CI = 0.48, 0.82] (P = .005)]. SRT has no effect on distant metastasis. Radiotherapy has worse survival when compared to surgery [RR 1.2 [95% CI = 1.03, 1.33] (P = .0006)].
SRT confers a moderate survival advantage in HNMM compared to surgery. This is most likely secondary to reduced local recurrence.
黏膜黑色素瘤（MM）是一种预后较差的罕见疾病。手术是治疗的基石，然而，放射治疗已被普遍用作一种治疗策略，并且近期表明生存结果可能正在改善的研究不断涌现。
进行一项系统评价和荟萃分析，比较放射治疗与手术以及手术联合放射治疗（SRT）对头颈部黏膜黑色素瘤（HNMM）5年总生存率、局部复发和远处转移的风险比。
与手术相比，SRT的死亡风险较低[风险比0.93 [95%置信区间 = 0.87, 0.98]（P = 0.01）]，局部复发风险降低[风险比0.63 [95%置信区间 = 0.48, 0.82]（P = 0.005）]。SRT对远处转移无影响。与手术相比，放射治疗的生存率较差[风险比1.2 [95%置信区间 = 1.03, 1.33]（P = 0.0006）]。
与手术相比，SRT在HNMM中具有适度的生存优势。这很可能是由于局部复发减少所致。
