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Prognostic factors in squamous cell lip carcinoma treated with high-dose-rate brachytherapy
Jose-Luis Guinot1, Leoncio Arribas, Juan B Vendrell
1Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia (I.V.O.), Valencia, Spain.
Background:
The purpose of this study was for us to present our analysis of the results and prognostic factors in squamous lip carcinoma treated with high-dose-rate (HDR) brachytherapy.
Methods:
From 1999 to 2010, 102 patients were treated with HDR-brachytherapy, 54 with T1, 33 with T2, and 15 with T4. Eight cases were N+. Twenty-one patients were treated with surgery plus brachytherapy because of close/positive margins. Nine fractions of 5 Gy were given over 5 days in 67% of the patients. Elective neck treatment was performed in 23 cases.
Results:
The 10-year actuarial local control was 94.6%, nodal regional control was 88.6%, disease-free survival was 84.6%, and cause-specific survival was 93.2%. In the univariate analysis, T4 tumors had higher risk of local failure and T2 of regional relapse. In the multivariate analysis, skin involvement was the only significant factor for tumor progression.
Conclusion:
HDR-brachytherapy yields excellent local control rates. Skin involvement increases the risk of local and cervical recurrence. Elective neck treatment should be done in T2 to T4 tumors or with skin or commissure involvement.
