de Visscher J G, Grond A J, Botke G, van der Waal I
Department of Oral and Maxillofacial Surgery, Medisch Centrum Leeuwarden, The Netherlands.
Radiother Oncol. 1996 Apr;39(1):9-14. doi: 10.1016/0167-8140(96)01716-1.
The authors analyzed the clinical history, tumor histology and stage, and outcome of a group of 108 patients with squamous cell carcinoma (SCC) of the vermilion border of the lower lip who underwent radiation therapy in the period between 1980 and 1992. The median follow-up was 77 months. The disease stages were T1 in 89 (82.4%), T2 in 17 (15.7%), and T3 in 2 cases (1.9%). At presentation, regional lymph nodes were clinically negative in all but 3 patients. The total tumor dose varied from 48 Gy to 70 Gy, depending on the radiation modality (orthovoltage, electrons, photontherapy and iridium implants). Local control was achieved in 88 out of 89 (98.9%) patients with T1, in 13 out of 17 (76.5%) patients with T2 and in both patients with T3 tumors. Local treatment failures (4.6%) were cured by salvage surgery. During follow-up, regional lymph node metastases at level I (submental and submandibular groups) occurred in 11 out of 89 (12.4%) patients with stage I and in I out of 15 (6.7%) patients with stage II tumors. All these patients underwent therapeutic neck dissection, followed by radiotherapy in 8 cases. Two patients developed distant metastases. Thus, after salvage treatment of local failures and regional metastases the total group of patients with stage I and II SCCs of the vermilion border of the lower lip showed a definitive control rate of 98.1%.
