Chemohormonal Therapy for Malignant Melanoma

The prognosis of malignant melanoma is very poor especially when it originates in the head and neck region such as the nasal, paranasal sinus, and oral mucosa. Although surgical therapy, radiotherapy, chemotherapy, immunotherapy, interferon therapy, and other therapies have been suggested for treatment of this malignant disease, there are still no therapies established as definitely effective. We attempted various types of therapies for our patients with primary nasal or paranasal malignant melanoma with unsatisfactory results. However, chemotherapy using anti-estrogen TAM (Tamoxifen®) has provided satisfactory results in 2 patients. The regimen of this chemohormonal therapy agreed with McClay's regimen. TAM is widely known as an anti-estrogen chemotherapeutic agent breast cancer and thought to exert anti-cancer effect by competing with estrogen for estrogen receptors in breast cancer tissues. The mechanism of the effect of TAM on malignant melanoma remains unknown. Although its anti-cancer mechanism must be further explored, we consider that this chemohormonal therapy will likely become very important in multidisciplinary therapy for malignant melanoma in the head and neck region.