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

Claes Mercke; Signe Friesland; Anders Berglund; Gun Wickart Johansson; Gregori Margolin; Michael Gubanski; Einar Björgvinsson; Josef Nilsson

doi:10.1002/hed.27936

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

Head Neck. 2024 Sep 26. doi: 10.1002/hed.27936. Online ahead of print.

Authors

Claes Mercke^{1

2}, Signe Friesland^{1

2}, Anders Berglund³, Gun Wickart Johansson^{1

2}, Gregori Margolin^{1

4}, Michael Gubanski^{2

5}, Einar Björgvinsson^{1

2}, Josef Nilsson⁶

Affiliations

¹ Department of Head, Neck, Lung and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.
² Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
³ Epistat Epidemiology and Statistics Consulting, Uppsala, Sweden.
⁴ Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
⁵ Department of Radiation Oncology, Karolinska University Hospital, Stockholm, Sweden.
⁶ Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.

PMID: 39327222
DOI: 10.1002/hed.27936

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.

Keywords: brachytherapy; head and neck surgery; lip cancer; oncologic outcomes; radiotherapy.