Oral cancer: Current role of radiotherapy and chemotherapy.
Oral cancer: Current role of radiotherapy and chemotherapy.
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DOI：
10.4317/medoral.18772
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发表时间：
2013-03-01
期刊：
影响因子：
--
通讯作者：
O'Sullivan B
中科院分区：
文献类型：
--
作者：
Huang SH;O'Sullivan B
术语口腔癌(OSCC)包括唇部、口底、口腔舌、颊粘膜、上下牙龈、硬腭部和磨牙后三角的黏膜表面的癌症。口腔鳞状细胞癌的治疗方法包括单一的手术治疗、放射治疗[外照射(EBRT)和/或近距离放射治疗]，以及辅助系统治疗(化疗和/或靶向药物)；根据疾病的表现和病理结果，也可以使用这些模式的各种组合。选择单独或联合的方式是基于各种考虑因素，包括疾病控制概率、预期的功能和美容结果、肿瘤的可切除性、患者的一般情况以及资源和专业知识的可用性。对于可切除的口腔鳞状细胞癌，主要的治疗方法是手术，尽管同样的从业者可能主张在选定的“早期”疾病表现中单独使用放射治疗，或者在局部晚期疾病中联合化疗。一般来说，后者更常用于手术可能有问题的情况下。因此，初级放疗和化疗通常是为无法耐受或因其他原因不适合手术的患者保留的。另一方面，近距离放射治疗可能被认为是早期小原发肿瘤的唯一治疗方式。在手术切缘病理评估不足的情况下，它也起到辅助手术的作用，就像术后外照射+化疗一样，这通常是为那些病理特征不佳的人保留的。近距离放射治疗对于持续性或复发性疾病或在先前辐射场内出现的第二次原发放射治疗，在重新照射环境中也特别有用。以表皮生长因子受体(EGFR)为靶点的生物制剂已成为放射治疗或放化疗的一种潜在手段，目前正处于临床试验阶段。关键词：放射治疗、放化疗、口腔癌、治疗。
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.
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