The effectiveness of radiotherapy in the treatment of head and neck mucosal melanoma: Systematic review and meta-analysis

Introduction 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. Methods 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). Results 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)]. Conclusions SRT confers a moderate survival advantage in HNMM compared to surgery. This is most likely secondary to reduced local recurrence.