Treatment Of Lip Cancer Research Articles

High dose rate brachytherapy for lip cancer with interstitial, surface, or a combination of interstitial and surface mold technique

High-dose-rate brachytherapy (HDR-BT) is now becoming more common than low-dose-rate and pulsed-dose-rate BT in the treatment of lip cancer. However, due to the limited history of HDR-BT, relatively few studies have been published. Two institutions (in Ukraine and the USA) reviewed their clinical outcomes of lip cancer patients treated with HDR-BT as monotherapy or in combination with external beam radiotherapy (EBRT). An interstitial (IS), surface custom mold (SC), or a combination of IS and SC (IS+SC) was used for treatments based on the depth of tumor invasion. Prescription doses were 24 Gy in 6 BID fractions when combined with 46-50 Gy of EBRT, 45-55 Gy in 9-10 BID fractions for IS and IS+SC monotherapy or 3 Gy × 16 daily fractions for SC monotherapy. A total of 33 cases of lip cancer were treated from 2015 to 2021. By using TNM staging classification, there were 14 stage I (42.4%), 15 stage II (45.5%), and 4 stage III (12.1%) lip cancers. Thirty-one patients (93.9%) had a complete response to the treatment. Only 2 patients (6.1%) displayed local recurrence. Grade 1, 2, and 3 acute toxicities were observed in 30.3%, 51.5%, and 18.2% of patients, respectively. Grade 1, 2, and 3 late toxicities were observed in 39.4%, 21.2%, and 0.0% of cases. Cosmetic results were excellent in 21.2%, good in 54.5%, fair in 18.2%, and poor in 6.1% of patients. HDR-BT is an effective and safe treatment for lip carcinomas with excellent local control, functional, and cosmetic outcomes and should be considered as a standard treatment.

“LIP SHAVE” TECHNIQUE: LITERATURE REVIEW AND CASE PRESENTATION

Introduction: Actinic cheilitis is a pre-malignant condition, mostly located on the lower lip, and can progress to squamous cell carcinoma, with higher tendency for metastasis than cutaneous squamous cell carcinoma. Several methods of treatment have been proposed, like electrosurgery and excision of the actinic damage via laser treatment. However, all methods have limitations. On the other hand, the surgical technique known as “lip shave”, achieves complete removal of the lesion, and promotes the reconstruction of the vermilion border. Case presentation: A 65-years old patient was referred to our Department for treatment of a lesion extended to the whole lower lip, diagnosed as actinic cheilitis after partial biopsy and histopathological examination. Under local anesthesia the outlined lesion was entirely excised, while the lip is was firmly immobilised with the thumb. After the mucosa was first elevated by sharp dissection from one corner, it was then conveniently removed by curved, pointed scissors down to the muscular layer. After securing haemostasis, three “key sutures” were first placed, in order to achieve an even symmetrical closure. The final closure of the wound was achieved with continuous locking suture. Conclusion: The "lip shave" is a non-deforming plastic and reconstructive procedure of great value for prophylaxis and treatment of lip cancer, and for cosmetic correction of certain congenital, neoplastic, and traumatic lip deformities.

AHNS Series - Do you know your guidelines? Lip cancer.

Lip cancer is one of the most curable primary head and neck malignancies, as the prominent location typically lends to an early diagnosis. The incidence of lip cancer varies by sex, ethnicity, and region, but is estimated to be up to 2.5/100000 in the United States (squamous cell carcinoma [SCC]). This article will review the current literature and National Comprehensive Cancer Network practice guidelines in the treatment of lip cancer. Resection of lip cancer with negative margins remains the mainstay of therapy. Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. Lip cancer remains highly curable when diagnosed at an early stage. A multidisciplinary approach is crucial to treating patients with advanced-stage lip cancer.

An alternative modality for the treatment of lip cancer or oral commissure cancer

An alternative modality for the treatment of lip cancer or oral commissure cancer

Lip cancer in renal transplant patients

The aims of this study were to establish the incidence of lip cancer (LC) in a population of renal transplant patients (RTPs), identifying possible risk factors and predictable variables, and to describe the clinical appearance, treatment, and course of LC in this group. The study included 500 patients (307 men, 193 women; mean age 53.63±13.42 years, range 19-95 years; mean period since transplant 59.66±55.81 months, range 4-330 months). Incident cases of LC were ascertained retrospectively from outpatient records. All LC lesions were sampled by biopsy and examined histopathologically. Six of the men (1.2%) suffered lower LC, and LC cases showed significant differences on univariate analysis for tobacco habit, tobacco consumption, and sun exposure. All patients who had LC were taking prednisolone and cyclosporine A (CsA) at the time of LC diagnosis. The median interval for LC incidence after renal transplant was 80.50±31.25 months. Five of six LCs were squamous cell carcinomas. Multiple logistic regression showed that the LCs were not significantly associated with any independent risk factor. The results show that the appearance of LC in RTPs is associated with immunosuppressant treatment, sun exposure, and tobacco and indicate that these patients should avoid unprotected exposure to sunlight and smoking. Because of the high incidence of LC in RTPs, periodic checking of the lips is important to ensure prompt diagnosis and correct management of LC. Our data suggest that the clinical profile of LC in this patient group is similar to that of the general population.

HDR and LDR Brachytherapy in the Treatment of Lip Cancer: the Experience of the Catalan Institute of Oncology.

PurposeLip cancer can be treated by surgery, external radiotherapy, and/or brachytherapy (BT). In recent years, BT has become increasingly favored for this type of cancer. The aim of the present study was to analyze local control and survival of patients treated at our institution between July 1989 and June 2008.Material and methodsWe performed a retrospective study of 121 patients (109 males and 12 females) who underwent lip cancer brachytherapy from July 1989 to June 2008. Median age was 67 years and median follow-up was 31.8 months (range 20-188 months). Out of 121 patients, 100 (82.6%) were treated with low dose rate (LDR) BT while the remaining 21 patients (17.4%) received high dose rate (HDR) BT.ResultsThe most common cell type was squamous cell carcinoma (115 cases; 95%) and most tumors were located on the lower lip (107 patients; 88.4%). Most cases were either stage T1 (62 patients; 51.2%), or T2 (44 cases; 36.4%). After 15 years of follow-up, overall survival was 89.5%, cause-specific survival 97.8%, and disease-free survival 86.6%. Local, regional, and distant control at 15 years were 90%, 92%, and 98.8%, respectively. Grade 3 mucosal toxicity was observed in 23% of patients treated with LDR compared to 33% of HDR patients, and grade 4 mucosal toxicity in 9% versus 0% in the HDR group.ConclusionsOur findings confirm that brachytherapy is an effective treatment for lip cancer. The results from our series are in line with those published elsewhere. Based on our limited data, HDR appears to be equally as good as LDR, although this needs to be confirmed by further studies.

Surgical Treatment of Lip Cancer: Our Experience With 106 Cases

Surgical Treatment of Lip Cancer: Our Experience With 106 Cases

Effectiveness of brachytherapy in the treatment of lip cancer: A retrospective study at the Istanbul University Oncology Institute

Stage T1 through T3 lip cancers can be treated primarily by brachytherapy (BRTX), with or without external radiotherapy (ERT), with adequate safety margins and good results. In this study, the outcomes of BRTX were reviewed for patients treated at the Brachytherapy Department of the Istanbul University Oncology Institute (IUOE). The medical records of 41 patients registered at IUOE with a diagnosis of lip cancer between 1988 and 2003 were reviewed. The median follow-up time was 88 months (24-160 mo). Among these patients, 21 patients with a primary tumor, 14 with tumors arising postoperatively, and 6 with postoperative recurrence of tumor were treated using BRTX. A total of 33 patients (80%) received BRTX alone and 8 (20%) received BRTX and ERT. The 10-year local control rate was 100%, 93%, and 67% for patients treated with BRTX alone, BRTX and surgery, and those treated for postoperative recurrence, respectively (P<.02). For patients treated with BRTX only and BRTX plus surgery, specific disease-free survival was 95% and 94%, respectively, and overall survival was 93% and 100%, respectively; these differences were not statistically significant. One patient with a postoperative recurrence who had been treated with BRTX died as a result of lip cancer. No patients developed any ulcerations, intra-oral complications, or mandibular necrosis. In the BRTX only group, 83% had excellent or good cosmetic results. In the surgery group, 62% had a contour deformity. In lip cancer management, BRTX results were comparable for local control, survival, and minimal late effects in normal tissue. This is in accordance with current reports in the medical literature. Satisfactory results were observed in patients with stage T1 and T2 lesions who had been treated with BRTX only and in patients with stage T3 lesions who had been treated with BRTX plus ERT, without a need for additional treatment modalities.

Double V-Y advancement flap in the management of lower lip reconstruction.

A new method for lower lip reconstruction is proposed. It is based on a double cutaneous and mucous V-Y advancement flap and is suggested for the surgical treatment of lip cancer confined between the skin and the vermilion with a horizontal spread. Sixteen patients were treated from 1996 to 2001 with this technique and the results were satisfactory both from the functional and the aesthetic standpoints.

Some oncologic considerations in the treatment of lip cancer.

We evaluated the treatment and results of 46 patients with lip cancer of commissure origin or extension. The patients were evaluated by clinical stage and pathologic findings. Treatment was predominantly by surgery for T1 and T2 lesions (31 of 37 patients), whereas combined resection and radiation therapy was used for larger tumors. The results showed control of both very large and very small lesions, but T2 lesions had repeated recurrences. We therefore recommended aggressive therapy for T2 and higher classifications of lip cancer with commissure involvement.

Surgical treatment of lip cancer

Surgical treatment of lip cancer

???Lip Shave??? or Vermilionectomy Indications and Technique

Summary Excision of the exposed mucosa or vermilion of the lips can be readily and safely performed under local an˦sthesia and is particularly indicated in situations requiring resurfacing of the lip, notably extensive precancerous leukoplakia or chronic solar cheilitis—the chronic sunburn of the weather-beaten farmer's or sailor's skin or tropical skin of the inhabitants of sunny climates. The shave can also be employed for reduction of lip size in hyperttrophy and should be combined with a V-resection whenever frank epithelioma is associated with leukoplakia of the remainder of the lip in order to prevent the occurrence of a new lesion elsewhere on the lip. The shave is thus a non-deforming plastic operation of great value in the prophylaxis and treatment of lip cancer and in the cosmetic correction of certain congenital, neoplastic, and traumatic lip deformities.

“Lip shave” or vermilionectomy: Indications and technique

Summary Excision of the exposed mucosa or vermilion of the lips can be readily and safely performed under local an˦sthesia and is particularly indicated in situations requiring resurfacing of the lip, notably extensive precancerous leukoplakia or chronic solar cheilitis—the chronic sunburn of the weather-beaten farmer's or sailor's skin or tropical skin of the inhabitants of sunny climates. The shave can also be employed for reduction of lip size in hyperttrophy and should be combined with a V-resection whenever frank epithelioma is associated with leukoplakia of the remainder of the lip in order to prevent the occurrence of a new lesion elsewhere on the lip. The shave is thus a non-deforming plastic operation of great value in the prophylaxis and treatment of lip cancer and in the cosmetic correction of certain congenital, neoplastic, and traumatic lip deformities.

A Review of 20 Years' Radium Treatment of Lip Cancer at the Radiological Clinic, Lund, Sweden

A Review of 20 Years' Radium Treatment of Lip Cancer at the Radiological Clinic, Lund, Sweden

CAUSES OF FAILURE IN THE TREATMENT OF CANCER OF THE LIP

The frequency with which recurrent and far-advanced cases of lip cancer have of late come to my notice has induced me to study the causes of failure in the treatment of lip cancer and to present the principal findings in this short paper, trusting that some fact might be brought forward which would impress on the profession the importance of early recognition and radical excision of the disease. I am confident that in many cases the patient's refusal to accept the advice of the medical attendant is responsible for the distressing results; in a few cases the disease is not recognized until a mutilating operation is necessary, while in other instances the surgeon has limited the operation to mere excision of the palpable growth. The secret of success in the treatment of lip cancer lies (1) in early recognition of the disease—recognition before the glands are palpably