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Abstract

To compare the use of high-dose-rate (HDR) brachytherapy (BT) in patients with lip carcinoma with a former series previously treated with low-dose-rate (LDR) BT.Ninety-nine patients treated with LDR-BT were compared with 104 patients treated with HDR-BT. Distribution by stage was 53.5% T1, 15.1% T2, 3.1% T3, and 28.3% T4 for LDR and 52.9% T1, 32.7% T2, 0% T3, and 14.4% T4 for HDR. Some cases with positive or close margins received BT after surgery (34.3% with LDR vs. 16.3% with HDR). Parallel metallic needles were used in 100% of HDR cases and in 76% of LDR cases. Most HDR patients were treated with HDR-BT to a dose of 4.5-5 Gy per fraction prescribed to a 90% isodose, in nine fractions delivered twice daily for 5 days.Median followup was 63 months for LDR-BT and 51 months for HDR-BT. Overall local control for LDR- vs. HDR-BT was 94.9% vs. 95.2%; and 100% vs. 100%, 86.6% vs. 94.1%, and 89.3% vs. 80%, for T1, T2, and T4 stage tumors, respectively. Disease-free survival for LDR vs. HDR was 95.9% vs. 94.2%. Soft tissue necrosis, bone necrosis, and fair-bad cosmesis for LDR vs. HDR was 15.1% vs. 0%, 1% vs. 0%, and 11.1% vs. 0%, respectively.Treatment with HDR-BT using rigid needles is a simple technique that provides good long-term results with minimal complications. LDR- and HDR-BT are regarded as equally effective in local control and disease-free survival, but fewer complications arise when using HDR-BT.

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From low-dose-rate to high-dose-rate brachytherapy in lip carcinoma: Equivalent results but fewer complications.

To compare the use of high-dose-rate (HDR) brachytherapy (BT) in patients with lip carcinoma with a former series previously treated with low-dose-rate (LDR) BT.Ninety-nine patients treated with LDR-BT were compared with 104 patients treated with HDR-BT. Distribution by stage was 53.5% T1, 15.1% T2, 3.1% T3, and 28.3% T4 for LDR and 52.9% T1, 32.7% T2, 0% T3, and 14.4% T4 for HDR. Some cases with positive or close margins received BT after surgery (34.3% with LDR vs. 16.3% with HDR). Parallel metallic needles were used in 100% of HDR cases and in 76% of LDR cases. Most HDR patients were treated with HDR-BT to a dose of 4.5-5 Gy per fraction prescribed to a 90% isodose, in nine fractions delivered twice daily for 5 days.Median followup was 63 months for LDR-BT and 51 months for HDR-BT. Overall local control for LDR- vs. HDR-BT was 94.9% vs. 95.2%; and 100% vs. 100%, 86.6% vs. 94.1%, and 89.3% vs. 80%, for T1, T2, and T4 stage tumors, respectively. Disease-free survival for LDR vs. HDR was 95.9% vs. 94.2%. Soft tissue necrosis, bone necrosis, and fair-bad cosmesis for LDR vs. HDR was 15.1% vs. 0%, 1% vs. 0%, and 11.1% vs. 0%, respectively.Treatment with HDR-BT using rigid needles is a simple technique that provides good long-term results with minimal complications. LDR- and HDR-BT are regarded as equally effective in local control and disease-free survival, but fewer complications arise when using HDR-BT.

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Keywords

metallic highdoserate hdr brachytherapy bt local control hdrbt vs 0 respectivelytreatment necrosis fairbad cosmesis diseasefree

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Jose-Luis, Guinot Leoncio, Arribas Maria Isabel, Tortajada Vicente, Crispín Maria, Carrascosa Miguel, Santos Alejandro, Mut Juan Bosco, Vendrell Carmen, Pesudo Maria Luisa, Chust,.From low-dose-rate to high-dose-rate brachytherapy in lip carcinoma: Equivalent results but fewer complications.. 12 (6),528-34.

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