Brachytherapy with permanent gold grain seeds for squamous cell carcinoma of the lip

Abstract Purpose To describe the use of radioactive gold grain implantation for squamous cell carcinoma of the lip. Methods Retrospective review of 51 patients treated with permanent gold (198 Au) grain implant brachytherapy. The seed arrangement delivered a dose of 5500 cGy at 0.5 cm from a single...

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Published in:Radiotherapy and oncology 2011-03, Vol.98 (3), p.352-356
Main Authors: Lock, Michael, Cao, Jeffrey Q, D’Souza, David P, Hammond, James A, Karnas, Scott, Lewis, Craig, Venkatesan, Varagur M, Whiston, Emily, Yau, Gary, Yu, Edward, Gilchrist, James, Rodrigues, George B
Format: Article
Language:English
Subjects:
Aged
Brachytherapy
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - radiotherapy
Female
Gold Radioisotopes - therapeutic use
Hematology, Oncology and Palliative Medicine
Humans
Lip
Lip Neoplasms - mortality
Lip Neoplasms - radiotherapy
Male
Neoplasm Staging
Outcome
Retrospective Studies
Treatment Outcome
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Summary:Abstract Purpose To describe the use of radioactive gold grain implantation for squamous cell carcinoma of the lip. Methods Retrospective review of 51 patients treated with permanent gold (198 Au) grain implant brachytherapy. The seed arrangement delivered a dose of 5500 cGy at 0.5 cm from a single plane. Primary endpoints were local recurrence and cosmetic outcome. Results Median follow-up was 27 months. Median age was 69 years. The majority (90%) were T1 lesions. None of the patients had evidence of regional lymph node or distant metastasis. Twelve patients had recurrent disease with prior surgery and five patients had previous head and neck radiation. Local control was achieved in 49 patients. Good cosmesis was achieved in 48 patients. Two-year actuarial estimates for local failure-free survival, disease-free survival and overall survival were 97.9%, 94.1% and 87.9%, respectively; no deaths were attributable to lip cancer. Conclusions Gold grain interstitial low-dose rate brachytherapy provides excellent local control and cosmesis in patients with squamous cell carcinoma of the lip. This technique provides an excellent option for patients that are elder or live remotely. It is particularly useful for lesions that are small, in previously radiated areas, or treated with prior surgery.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2010.12.014