Evaluating the Upper and Lower Lip as Critical Organs in Radiotherapy for Head and Neck Cancer Patients

Squamous cell carcinoma of the head and neck is condition associated with a poor prognosis. Current treatment methods are a combination of various techniques. Reactions after radiotherapy, particularly those affecting mucous tissues such as the lips, are a major issue after radiotherapy. This study aimed to assess the doses deposited on the lip area, considering its proximity to target areas during radiotherapy. Study was conducted on 100 patients with diagnosed head and neck cancers. These patients were treated with radiotherapy, sometimes combined with chemotherapy, and for some, it was postoperative treatment. The minimum, average, and maximum doses deposited on the lip area were assessed, divided into group I (neck) and group II (head). The lowest doses were observed in the larynx area, and the highest in the oral cavity (67.7% of the dose from 70 Gy and 76.46% from the minimum dose). Patients were further divided based on treatment methods, with the highest maximum lip dose found in those undergoing postoperative radiochemotherapy (Dmax 42.34Gy). Post-radiation reactions were then analyzed, showing higher reactions (lowest, average, and maximum) in group II (head area). Tumor location analysis showed the lowest maximum reaction according to the Dische classification in the larynx and other locations, and the highest in the pharynx. Postoperative patients with adjuvant radiochemotherapy had the highest minimal and maximum reactions. Despite the lack of statistical significance, the results suggest the importance of contouring the lips as a critical organ to reduce radiation reactions, potentially improving patients' quality of life.