Treatment of advanced, inoperable lip cancer in patients fit for chemotherapy
Malignant neoplasm of the commissure of the lip (ICD-10 C00.6 / ICD-11 2B6B.0.1) presenting at an advanced, inoperable stage requires a non-surgical treatment strategy. When the patient is fit for chemotherapy, a structured evidence-based protocol applies.
Clinical scenario: Advanced-stage lip cancer at the commissure where surgical resection is not feasible — patient is fit for chemotherapy. The management approach diverges meaningfully from early-stage disease and depends on careful patient selection.
Treatment approach
The protocol centres on concurrent radiochemotherapy as the primary modality. For eligible patients, a neo-adjuvant chemotherapy phase followed by concurrent radiochemotherapy is also addressed. The complete regimen — including agent selection, sequencing, and all eligibility criteria — is available in the full protocol.
References
DOI: 10.1017/S0022215116000499
- Concurrent radiochemotherapy combines platinum-based chemotherapy with external beam radiotherapy (EBRT) to 70 Gy.
- While the most recognised concurrent chemotherapy regimen is cisplatin 100 mg/m2 three weekly, varying doses and schedules are acceptable practice, as is substitution by carboplatin.
- Neo-adjuvant chemotherapy with taxanes, cisplatin and 5-fluro-uracil (TPF) is a potent combination in advanced, inoperable disease in fit patients, if followed by concurrent radiochemotherapy.
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