Department of Surgery, Medical School, Al Baha University, Al Baha, Saudi Arabia.
Otolaryngiology/Head and Neck section, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard, Jeddah, Saudi Arabia.
Cancer Control. 2020 Jan-Dec;27(1):1073274820920727. doi: 10.1177/1073274820920727.
Patients with oral cavity cancers often present late to seek medical care. Surgery is usually the preferred upfront treatment. However, surgical resection cannot be achieved in many cases with advanced disease without major impact on patient's quality of life. On the other hand, radiotherapy (RT) and chemotherapy (CT) have not been employed routinely to replace surgery as curative treatment or to facilitate surgery as neoadjuvant therapy. The optimal care of these patients is challenging when surgical treatment is not feasible. In this review, we aimed to summarize the best available evidence-based treatment approaches for patients with locally advanced oral cavity cancer. Surgery followed by RT with or without CT is the standard of care for locally advanced oral cavity squamous cell carcinoma. In the case of unresectable disease, induction CT prior to surgery or chemoradiotherapy (CRT) can be attempted with curative intent. For inoperable patients or when surgery is expected to result in poor functional outcome, patients may be candidates for possibly curative CRT or palliative RT with a focus on quality of life.
口腔癌患者通常就诊较晚。手术通常是首选的初始治疗方法。然而，对于晚期疾病，许多情况下无法进行手术切除，而不会对患者的生活质量产生重大影响。另一方面，放射治疗（RT）和化学疗法（CT）并未常规用于替代手术作为治愈性治疗或辅助手术作为新辅助治疗。当手术治疗不可行时，这些患者的最佳护理具有挑战性。在这篇综述中，我们旨在总结局部晚期口腔癌患者最佳的循证治疗方法。手术加放疗加或不加 CT 是局部晚期口腔鳞状细胞癌的标准治疗方法。对于不可切除的疾病，可以尝试在手术前进行诱导 CT 或放化疗（CRT），以达到治愈的目的。对于无法手术的患者或手术预计会导致功能结果不佳的患者，患者可能适合进行可能治愈的 CRT 或姑息性 RT，重点是提高生活质量。
