"High-risk" tumors of the lip treated with external beam radiotherapy and high-dose-rate brachytherapy: Long-term outcome.

ABSTRACT

BACKGROUND: Radiotherapy is a well-established treatment for lip cancer, with external radiotherapy (EBRT) or brachytherapy (BT). METHODS: This study evaluated outcome, tumor control, and aesthetics, for 101 patients with carcinoma of the lip, not suitable for surgery, treated with combined EBRT and BT. RESULTS: Squamous cell carcinoma was seen in 78 patients, basal cell carcinoma in 15, and other histologies in 8 patients. Tumors were advanced 73% in category T2-T4. Local control at 3 and 5 years was 89%. Local failure appeared in 4/56 patients (7%) with primary RT compared to 7/45 (16%) in those with prior surgery, regional recurrence in 5 patients. Toxicity was mild. Cosmetic outcome, 87 patients evaluated, was bad for 9/40 patients with upfront surgery compared to 1/47 for primary RT patients (p = 0.003). Seven patients died from lip cancer (7%), three with originally N+ disease (43%). CONCLUSIONS: Combined EBRT and BT could be considered for lip tumors not candidates for surgery.