Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life Analysis

Abstract

Purpose: Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma. Methods and Materials: this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N). Results: From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60–85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan–Meier estimated probability of local failure was 7.2% (95% CI: 0.84–1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84. Conclusions: This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.

High dose interstitial brachytherapy for treatment of carcinoma of the lip as an alternative to surgery: a case report

“…Long-term side-effects include hypopigmentation, telangiectasias and in some cases a certain degree of fibrosis. However, these are very rare: over 90% of patients treated with HDRIB for LC have satisfactory functional and cosmetic results, and most patients who underwent the procedure would recommend it [ 8 , 19 , 20 ].…”

Treatment outcomes of squamous cell carcinoma of the lip: A retrospective study

“…To date, to the best of our knowledge, no randomised studies comparing these different treatment strategies have been reported. In the clinic, the type of treatment modality is selected based on the size and location of the tumour, the expected functional outcome and the accessibility of the treatment type ( 11 ). The aims of the present study were to retrospectively evaluate the clinical profile and treatment outcomes of patients with SCC of the lip treated with radical intent at the Regional Cancer Centre.…”