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

Abstract

PurposeTo describe the use of radioactive gold grain implantation for squamous cell carcinoma of the lip. MethodsRetrospective review of 51 patients treated with permanent gold (198Au) grain implant brachytherapy. The seed arrangement delivered a dose of 5500cGy at 0.5cm from a single plane. Primary endpoints were local recurrence and cosmetic outcome. ResultsMedian follow-up was 27months. Median age was 69years. 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. ConclusionsGold 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.