Oral cancer: Current role of radiotherapy and chemotherapy

Abstract

The term oral cavity cancer (OSCC) constitutes cancers of the mucosal surfaces of the lips, floor of mouth, oral tongue, buccal mucosa, lower and upper gingiva, hard palate and retromolar trigone. Treatment approaches for OSCC include single management with surgery, radiotherapy [external beam radiotherapy (EBRT) and/or brachytherapy], as well as adjuvant systemic therapy (chemotherapy and/or target agents); various combinations of these modalities may also be used depending on the disease presentation and pathological findings. The selection of sole or combined modality is based on various considerations that include disease control probability, the anticipated functional and cosmetic outcomes, tumor resectability, patient general condition, and availability of resources and expertise. For resectable OSCC, the mainstay of treatment is surgery, though same practitioners may advocate for the use of radiotherapy alone in selected “early” disease presentations or combined with chemotherapy in more locally advanced stage disease. In general, the latter is more commonly reserved for cases where surgery may be problematic. Thus, primary radiotherapy ± chemotherapy is usually reserved for patients unable to tolerate or who are otherwise unsuited for surgery. On the other hand, brachytherapy may be considered as a sole modality for early small primary tumor. It also has a role as an adjuvant to surgery in the setting of inadequate pathologically assessed resection margins, as does postoperative external beam radiotherapy ± chemotherapy, which is usually reserved for those with unfavorable pathological features. Brachytherapy can also be especially useful in the re-irradiation setting for persistent or recurrent disease or for a second primary arising within a previous radiation field. Biological agents targeting the epithelial growth factor receptor (EGFR) have emerged as a potential moda-lity in combination with radiotherapy or chemoradiotherpy and are currently under evaluation in clinical trials. Key words:Radiotherapy, chemoradiotherapy, oral cavity cancer, treatment.

Dysregulation of miR-200 family microRNAs and epithelial-mesenchymal transition markers in oral squamous cell carcinoma

“…Despite recent advances in cancer therapy, oral cancer remains a major health threat due to the lack of improvement in the 5-year overall survival (OS) rate (1). Treatment of OSCC includes surgery, radiotherapy, chemotherapy or a combination of different systemic therapies (2). However, an effective strategy to select suitable patients for these therapies does not currently exist owing to the complexities associated with radiation response, and also limitations regarding tolerance of normal surrounding tissues.…”

Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time

“…Treatments may be provided as single modality for early stage, localized disease, or more commonly, due to late stage diagnosis, using combined modalities of care [2,[5][6][7].…”

Future trends and emerging issues for nanodelivery systems in oral and oropharyngeal cancer

“…All these modalities have shortcomings, especially chemotherapy. 4 These agents exhibit high toxicity in normal cells when administered intravenously, due to their nonspecific tissue distribution. 4 This leads to the need for lowering administered doses, with the result of increased antitumor effects.…”

“…4 These agents exhibit high toxicity in normal cells when administered intravenously, due to their nonspecific tissue distribution. 4 This leads to the need for lowering administered doses, with the result of increased antitumor effects. 5 Oral administration of chemotherapeutic agents, although preferred by patients, encounters several problems, because of the low solubility in bodily fluids, low permeability, and poor bioavailability of these drugs.…”