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

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.