Continuous hyperfractionated accelerated radiotherapy in the treatment of carcinoma of the columella and vestibule of the nose

Twenty-one patients with squamous cell carcinoma of the nasal columella and vestibule were treated at the Mount Vernon Centre for Cancer Treatment between March 1986 and January 1994. Tumours ranged from 15 to 55 mm in maximum dimension (median 25 mm). All patients were treated with radical intent with continuous hyperfractionated accelerated radiotherapy (CHART). This group was analysed with respect to tumour control, tumour cell kinetics and radiation-induced morbidity at a median time to last follow-up of 40 months. Particular attention was paid to the detailed evaluation of late radiation changes. Patients who were still alive were assessed as to the satisfaction with the cosmesis of their treated nose. Four patients had relapse of disease either at the primary site alone (2), in neck nodes (1) or in both regions (1). One patient was successfully salvaged with surgery. Cell kinetic studies showed that cancers at this site may have potential for rapid cellular repopulation similar to cancers developing at other head and neck sites. CHART was well tolerated by patients. Late skin changes were remarkedly slight (despite full skin dose) and overall cosmesis excellent with this radiotherapy schedule.