"High-risk" tumors of the lip treated with external beam radiotherapy and high-dose-rate brachytherapy: Long-term outcome.
brachytherapy
head and neck surgery
lip cancer
oncologic outcomes
radiotherapy
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
26 Sep 2024
26 Sep 2024
Historique:
revised:
28
08
2024
received:
23
05
2024
accepted:
04
09
2024
medline:
27
9
2024
pubmed:
27
9
2024
entrez:
26
9
2024
Statut:
aheadofprint
Résumé
Radiotherapy is a well-established treatment for lip cancer, with external radiotherapy (EBRT) or brachytherapy (BT). 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. 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%). Combined EBRT and BT could be considered for lip tumors not candidates for surgery.
Sections du résumé
BACKGROUND
BACKGROUND
Radiotherapy is a well-established treatment for lip cancer, with external radiotherapy (EBRT) or brachytherapy (BT).
METHODS
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
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
CONCLUSIONS
Combined EBRT and BT could be considered for lip tumors not candidates for surgery.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.
Références
Kerawala C, Roques T, Jeannon J‐P, Bisase B. Oral cavity and lip cancer: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130(Suppl S2):S83‐S89.
de Visscher JG, Botke G, Schakenraad JA, van der Waal I. A comparison of results after radiotherapy and surgery for stage I squamous cell carcinoma of the lower lip. Head Neck. 1999;21:526‐530.
Beauvois S, Hoffstetter S, Peiffert D, et al. Brachytherapy for lower lip epidermoid cancer: tumoral and treatment factors influencing recurrences and complications. Radiother Oncol. 1994;33:195‐203.
Guibert M, David I, Vergez S, et al. Brachytherapy in lip carcinoma: long‐term results. Int J Radiat Oncol Biol Phys. 2011;81(5):839‐843.
Mazeron JJ, Ardiet JM, Haie‐Meder C, et al. GEC_ESTRO recomendations for brachytherapy for head and neck squamous cell carcinomas. Radiother Oncol. 2009;91:150‐156.
Guinot JL, Arribas L, Tortajada I, et al. From low‐dose‐rate to high‐dose‐rate brachytherapy in lip carcinoma: equivalent results but fewer complications. Brachytherapy. 2013;12:528‐534.
Ghadjar P, Bojaxhiu B, Simcock M, et al. High dose‐rate versus low dose‐rate brachytherapy for lip cancer. Int J Radiat Oncol Biol Phys. 2012;83:1205‐1212.
El Ayachy R, Sun R, Ka K, et al. Pulsed dose rate brachytherapy of lip carcinoma: clinical outcome and quality of life analysis. Cancer. 2021;13:1‐13.
Guinot JL, Arribas L, Vendrelli JB, et al. Prognostic factors in squamous cell lip cancer treated with high‐dose‐rate brachytherapy. Head Neck. 2014;36:1737‐1742.
Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organisation for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31(5):1341‐1346.
Bilkay U, Kerem H, Ozek C, et al. Management of lower lip cancer: a retrospective analysis of 118 patients and review of the literature. Ann Plast Surg. 2003;50:50.
Vukadinovic M, Jezdic Z, Petrovic M, Medenica LM, Lens M. Surgical management of squamous cell carcinoma of the lip: analysis of a 10‐year experience in 223 patients. J Oral Maxillofac Surg. 2007;65:675‐679.
Zitsch RP 3rd, Park CW, Renner GJ, Rea JL. Outcome analysis for lip carcinoma. Otolaryngol Head Neck Surg. 1995;113:589‐596.
Brinkman JN, Hajder E, van der Holt B, Den Bakker MA, Hovius SER, Mureau MAM. The effect of differentiation grade of cutaneous squamous cell carcinoma on excision margins, local recurrence, metastasis, and patient survival. Ann Plast Surg. 2015;75(3):323‐326.
Dougherty W, Givi B, Jameson MJ. AHNS series—Do you know your guidelines? Lip Cancer Head Neck. 2017;39:1505‐1509.
Kristensen RN, Stemann Andersen P, Lock‐Andersen J. Lip carcinoma: clinical presentation, surgical treatment, and outcome: a series of 108 cases from Denmark. J Plastic Surg Hand Surg. 2017;51:342‐347.
Schüller M, Gosau M, Müller S, et al. Long‐term outcome and subjective quality of life after surgical treatment of lower lip cancer. Clin Oral Invest. 2015;19:1093‐1099.
Van Hof KS, Wakkee M, Sewnaik A, et al. Long‐term outcomes, quality of life, and costs of treatment modalities for T1‐T2 lip carcinomas. Oral Dis. 2024;30:2063‐2074.
Gulati A, Grekin R, Neuhaus I, et al. Long‐term appearance‐related outcomes of facial reconstruction after skin cancer resection. Facial Plast Surg Aesth Med. 2022;25:344‐350.
Zebolsky AL, Patel N, Heaton CM, Park AM, Seth R, Knott PD. Patient‐reported aesthetic and psychosocial outcomes after microvascular reconstruction for head and neck cancer. JAMA Otolaryngol Head Neck Surg. 2021;147(12):1035‐1044.
Guinot JL, Arribas L, Chust ML, et al. Lip cancer treatment with high dose rate brachytherapy. Radiother Oncol. 2003;69:113‐115.
Tucek L, Sirak I, Hodek M, et al. High‐dose‐rate brachytherapy at 3 Gy per fraction for lip carcinoma: treatment outcomes and toxicity at 5 years. Brachytherapy. 2023;22:496‐502.
Merfeld EC, Witek ME, Francis DM, et al. Interstitial brachytherapy for lip cancer: technical aspects to individualize treatment approach and optimize outcomes. Practical Radiation Oncol. 2023;13(4):340‐345.
Johansson B, Karlsson L, Hardell L, Persliden J. Long term results of PDR brachytherapy for lip cancer. J Contemp Brachyther. 2011;3:65‐69.
Gross ND, Miller DM, Khushalani N, et al. Neoadjuvant Cemiplimab for stage II to IV cutaneous squamous‐cell carcinoma. N Engl J Med. 2022;17:1557‐1568.