Treatment of carcinoma of the nasal vestibule with radiation therapy

Twenty patients with squamous cell carcinoma of the nasal vestibule were treated at the Santa Creu i San Pau Hospital, Barcelona, Spain, from 1974 to 1992. Sixteen patients had T1 and T2 lesions and four patients had T3 lesions. All but one of the patients received radiation therapy, combined with surgery in four patients, and combined with chemotherapy in two patients. One patient had surgery alone, and eight patients were treated with interstitial implant of iridium-192 hairpins, three of them as a sole modality and five as a boost after external radiation therapy. Median follow- up time was 31 months. Local control was achieved in 18 of 20 patients. One patient presented with local relapse and two presented with nodal relapse; two of them were salvaged with a combined-modality treatment. One patient developed significant late morbidity after irradiation. Overall survival rate was 66% at six years, and the disease-free survival rate was 70% at seven years. Excellent local control and cosmesis can be achieved with radiation therapy for the treatment of the T1 and T2 squamous cell carcinomas of the nasal vestibule. Indications for implantation based on tumor size, site, and gross morphology are discussed.