Role of radiotherapy in the primary management of mucosal melanoma of the head and neck.

Historically, radiotherapy has played a very small role in the management of mucosal melanoma, largely because the disease has been characterized as radioresistant. Recent observations regarding the radiobiology and clinical response of cutaneous melanoma have prompted investigators to reevaluate the role of radiotherapy in mucosal melanoma. A series of reports published during the last decade using radiotherapy alone have documented complete response rates of 50-75% with durable long-term control in half to two thirds of the complete responders. These data, taken in conjunction with the high rate of local failure after surgery alone, suggest that radiotherapy would have a useful role as a surgical adjuvant in a combined modality approach, as well as being of value in the primary management of unresectable disease. Guidelines for management based on the available data are presented.