This protocol applies to patients with malignant neoplasm of the commissure of the lip in the setting of stage III or IV lip cancer where the disease is operable, surgical margins are clear, and there is no extracapsular spread of nodal metastasis.
Advanced lip cancer at stage III or IV — operable disease with no positive surgical margins and no extracapsular spread of nodal metastasis. At these stages, traditional management encompasses surgical resection, neck dissection, reconstruction, and post-operative radiotherapy as part of the broader treatment pathway.
The protocol involves palliative options, including radiotherapy delivered over specific fractionation schedules, or palliative chemotherapy using combination regimens. The full sequence, eligibility criteria, and complete regimen are available in the structured protocol below.
For advanced disease, stages III and IV (T3, T4 N0 and T1–4 N1), traditional management includes surgical resection, neck dissection, reconstruction and post-operative RT.
In fit patients under the age of 71, adjuvant radiochemotherapy up to 66 Gy with concurrent platinum-based chemotherapy should be considered for those with positive surgical margins and/or ECS.
Palliative RT may be used, either over short fractionation schedules or split course, for patients with advanced and inoperable disease, or those who are not fit for a more toxic, radical approach.
Palliative chemotherapy with platinum-based drugs and 5FU or capecitabine can also be considered to help symptoms and improve survival.
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