title: High dose-rate versus low dose-rate brachytherapy for lip cancer.
abstract: OBJECTIVE
  To analyze the outcome after low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy for lip cancer.
  
  
  METHODS
  One hundred and three patients with newly diagnosed squamous cell carcinoma of the lip were treated between March 1985 and June 2009 either by HDR (n = 33) or LDR brachytherapy (n = 70). Sixty-eight patients received brachytherapy alone, and 35 received tumor excision followed by brachytherapy because of positive resection margins. Acute and late toxicity was assessed according to the Common Terminology Criteria for Adverse Events 3.0.
  
  
  RESULTS
  Median follow-up was 3.1 years (range, 0.3-23 years). Clinical and pathological variables did not differ significantly between groups. At 5 years, local recurrence-free survival, regional recurrence-free survival, and overall survival rates were 93%, 90%, and 77%. There was no significant difference for these endpoints when HDR was compared with LDR brachytherapy. Forty-two of 103 patients (41%) experienced acute Grade 2 and 57 of 103 patients (55%) experienced acute Grade 3 toxicity. Late Grade 1 toxicity was experienced by 34 of 103 patients (33%), and 5 of 103 patients (5%) experienced late Grade 2 toxicity; no Grade 3 late toxicity was observed. Acute and late toxicity rates were not significantly different between HDR and LDR brachytherapy.
  
  
  CONCLUSIONS
  As treatment for lip cancer, HDR and LDR brachytherapy have comparable locoregional control and acute and late toxicity rates. HDR brachytherapy for lip cancer seems to be an effective treatment with acceptable toxicity.
authors.affiliation: Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Switzerland. pirus.ghadjar@insel.ch
authors.forename: Pirus
authors.initials: P
authors.lastname: Ghadjar
authors.forename: Beat
authors.initials: B
authors.lastname: Bojaxhiu
authors.forename: Mathew
authors.initials: M
authors.lastname: Simcock
authors.forename: Dario
authors.initials: D
authors.lastname: Terribilini
authors.forename: Bernhard
authors.initials: B
authors.lastname: Isaak
authors.forename: Philipp
authors.initials: P
authors.lastname: Gut
authors.forename: Patrick
authors.initials: P
authors.lastname: Wolfensberger
authors.forename: Jens O
authors.initials: JO
authors.lastname: Brömme
authors.forename: Andreas
authors.initials: A
authors.lastname: Geretschläger
authors.forename: Frank
authors.initials: F
authors.lastname: Behrensmeier
authors.forename: Alessia
authors.initials: A
authors.lastname: Pica
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Aebersold
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008048:Lip Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013557:Switzerland; D047368:Tumor Burden