Results of interstitial HDR brachytherapy for cancer of the lower lip
Abstract
Background
HDR brachytherapy has been employed in the treatment of cancers in numerous locations around the body, however, few publications have dealt with primary carcinomas of the head and neck. To our knowledge, only one paper concerns the use of this technique in the treatment of cancers of the lower lip. Furthermore, the recommendations given by the American Association of Brachytherapy do not appear to elaborate on the subject.
Aim
To analyse the treatment of lower lip carcinoma by interstitial HDR brachytherapy.
Materials/Methods
Retrospective analysis of the results of treatment was carried out among a group of 24 consecutive patients, of whom 18 were treated by brachytherapy alone while 6 others were treated after surgery. Fifteen patients were classified as T1, nine patients as T2. 23 patients were classified as N0 and one as N1. Each patient had histologically confirmed squamous cell carcinoma. Radiotherapy involved interstitial, high dose rate brachytherapy with an iridium-192 source. Post-operative brachytherapy was indicated in cases of microscopically incomplete excision. The dose was determined using the Paris method, the reference dose being 80% or at a point 3–5 mm from the macroscopic lesion or tumour bed. The mean total dose was 35 Gy, the mean number of fractions was 7, and the mean fraction dose was 5.7 Gy. The total treatment time was 12 days, on average, whereas the mean follow-up was 32 months.
Results
Local control was obtained after 24 months in 21 patients (87.5%). All patients developed a severe early reaction. Three patients with mouth corner infiltration (100%) failed to show complete regression. Two of these patients underwent additional irradiation to the residual lesion, resulting in cures. The third patient underwent successful surgical treatment. The cosmetic and functional effect was very good.
Conclusuions
Interstitial HDR brachytherapy is an effective and safe method for the treatment of carcinoma in the lower lip.
Keywords: brachytherapyHDRlower lip cancer