Current Role of Radiotherapy in the Management of Oral Cavity Squamous Cell Carcinoma

Abstract

Study Design: Literature review. Objective: To review the current role of radiotherapy (RT) in the management of oral cavity squamous cell carcinoma (SCC). Methods: Review of selected literature. Results: T1-T2N0 SCCs may be treated with either RT alone or surgery with a high likelihood of cure. The pendulum swung toward surgery with postoperative RT (PORT) added depending on the pathological findings in the mid 1980s. Patients with positive margins, extranodal extension (ENE), and/or 4 or more positive nodes receive concomitant chemotherapy (POCRT). Patients with T3-T4 and/or positive regional nodes are treated with surgery and PORT alone or POCRT. The likelihood of cure is moderate to low depending on extent of disease. The likelihood of major complications ranges from 10% to 30% depending on the method of reconstruction and the aggressiveness of postoperative PORT/POCRT. Patients with very advanced disease are treated with palliative RT, chemotherapy, or supportive care. Conclusions: The role of RT in the management of oral cavity SCC is primarily in the postoperative setting with palliative RT being reserved for those with very advanced disease where the likelihood of cure is remote.

Knowledge, Attitude, and Skills of Oral Health Care Professionals towards Cancer Treatment-induced Oral Mucositis.

“…A palliative care team can still be very helpful in many areas, even though most treatment-related issues may be handled by a regular oncological care team. As a result, a multidisciplinary palliative care team with experience in managing these cases should preferably make all clinical decisions about the management of early OSCC [20]. For comprehensive patient treatment with positive results, a collaboration between palliative care experts, speech therapists, radiation oncologists, surgeons, dentists, and nurses is essential [21][22][23][24].…”

Comparing the clinical outcomes of initial surgery and primary definitive radiotherapy with a dosage of 6600 cGy or higher in cT1−2N0M0 oral cavity squamous cell carcinoma: A nationwide cohort study

“…However, many radiation oncologists opt for doses of 7000 cGy or higher to manage gross tumor disease. There is ongoing research suggesting that overcoming the relative radioresistance of OCSCC may require more aggressive strategies such as interstitial brachytherapy, dose escalation, or larger fraction sizes 11 . However, these intensive treatments could lead to severe long‐term morbidity and a decrease in the patient's quality of life.…”

Hsa_circRNA_101036 aggravates hypoxic-induced endoplasmic reticulum stress via the miR-21-3p/TMTC1 axis in oral squamous cell carcinoma

“…Oral squamous cell carcinoma (OSCC), which is a severe malignancy with a high rate of metastasis and recurrence, accounts for >90 % of oral cancers [ 1 ]. Despite the development of new diagnostic and treatment methods, the 5-year survival rate of OSCC patients does not exceed 50 % [ 2 ].…”