BRACHYTHERAPY FOR SQUAMOUS-CELL CARCINOMA OF THE LIP - THE EXPERIENCEOF THE INSTITUTE-OF-RADIOLOGY OF THE UNIVERSITY-OF-ROME LA-SAPIENZA

Aims and background: Cancer of the lip is the most common malignancy o ccurring in the oral cavity. The aim of our retrospective study was to review the results of patients with lower lip squamous cell carcinoma who were treated with radiotherapy. Methods & study design: From 1970 to 1992, 57 patients with squamous cell carcinoma of the lower lip we re treated at the Institute of Radiology of the University of Rome ''L a Sapienza'' with low-dose rate interstitial brachytherapy, According to the UICC 1992 TNM classification, the disease stage was T1 in 27 (4 7%) cases, T2 in 20 (35%) and T3 in 10 (18%); 8 patients (14%) were cN +. The median tumor dose was 62 Gy (range, 44-96): 10 patients (18%) r eceived a total dose < 50 Gy, 28 (49%) between 50 and 70 Gy, and 19 (3 3%) > 70 Gy. The cN+ cases were irradiated to total doses of 65-70 Gy on the involved station, All patients obtained complete remission, Res ults: The actuarial overall survival rates at 3, 5 and 10 years were 9 5%, 76% and 53%; actuarial disease-free survival at 3, 5 and 10 years was 84%, 81%, and 81%, respectively. Actuarial cause-specific survival was 98%, 88% and 84% at 3, 5 and 10 years, respectively. Actuarial lo cal control rate was 90% at 3 and 5 years, rising to 94% with salvage surgery, Local-regional control was obtained in 90% and 86% of patient s at 3 and 5 years, and in 93% and 89% of cases, respectively, followi ng surgery, Five of 11 deaths were due to local-regional or distant di sease recurrence, Conclusions: Tumor stage and positivity of regional nodes were the only predictive factors of survival and disease control , Radiation-induced morbidity was very low, and all patients considere d their cosmetic outcome at least satisfactory.