THE PLACE OF BRACHYTHERAPY IN LIP CANCER TREATMENT

From 1988 through 1994, 26 lip cancer cases were treated with interstitial iridium 192 wires at the Istanbul University Oncology Institute. 10 of these had postoperative interstitial applications either after failing (5 patients) or for tumor positive margins (3 patients), unknown resection margins (2 patients) and 16 patients were treated primarily by brachytherapy without surgery. Only 3 patients had a combination of external and interstitial irradiation, and 23 had interstitial therapy only. 46% had T1, 31% T2, 4% T3, 19% recurrent tumor; 88% were NO before commencement of radiotherapy. Total brachytherapy dose was median 70 Gy (10-30) if applied as the sole model of irradiation, or median 25 Gy (10-30) after external radiotherapy. 22 patients were followed for at least two years. Of these, only one had recurrence at the margin of the target radiotherapy volume; however, he had had surgery and recurrence before he was treated with brachytherapy. Local control rate was 96% for the whole group and 100% for definitive brachytherapy group. Regional control rate was 100% for NO; however, only 1 out of 3 N1 patients was controlled. Corrected four years overall survival rate was 90%, and disease-free survival 86%. The cosmetic results were either excellent or good in cases treated by definitive brachytherapy. 93% had no complications or complaints due to brachytherapy. These results show that brachytherapy is an alternative treatment to surgery in lip cancers. These results comply with the brachytherapy literature and suggest brachytherapy can be alternative to surgery in the treatment of lip cancer.