Oral and maxillofacial malignancies still remain significant health problems worldwide, the 5- year relativesurvival rate was 47.7% for oral squamous cell carcinoma and 64.7% for carcinomas of the major salivary gland...Oral and maxillofacial malignancies still remain significant health problems worldwide, the 5- year relativesurvival rate was 47.7% for oral squamous cell carcinoma and 64.7% for carcinomas of the major salivary glands accordingto NCDB reports. Successful management of these malignancies now requires a cooperative or multidisciplinary approachstrongly evidence based, ordered, even individualized rather than randomized, among a broad group of medical disciplinesincluding head and neck surgery, radiation oncology, medical oncology, medical imaging, clinical pathology and labmedicine, social work, nutrition, and others. Different treatment modalities are mandatory for different primary sites,histopathologic types, different TNM stages and different patients, either dominated by surgery, radiation therapy orchemotherapy, coordinated other modalities. This paper evaluated and summarized current comprehensive and sequentialapproaches to the management of oral and maxillofacial malignancies, emphasizing the importance of multidisciplinaryteam approach to coordinate surgery, radiation therapy and chemotherapy. The roles of induction chemotherapy andconcomitant chemoradiotherapy were also discussed. Comprehensive strategies for different oral and maxillofacialmalignancies had been proposed by National Comprehensive Cancer Network (NCCN) and introduced to the Chinesecolleagues for clinical references. The future lies in the development of individualized treatment regimes that combineearly detection with organ preservation and result in improved cure rates and quality of life, study of the best treatmentorder of the three disciplines of surgery, radiation, and chemotherapy; the refinement of radiation by altering fraction dose,sequence, and time course; radiosensitization by chemo- and biologic therapy; and the addition of novel, biologicallytargeted agents to these disciplines.展开更多
Objective To introduce the concept and rational regimens and present the latest development of combined treatment of oral and maxillofacial malignancies. Data sources The related published literature was searched thro...Objective To introduce the concept and rational regimens and present the latest development of combined treatment of oral and maxillofacial malignancies. Data sources The related published literature was searched through the CNKI database and MEDLINE using the terms of oral cancer, oral and maxillofacial malignancies, combined and sequential therapy, multidisciplinary approach. Study selection The available related literature was read and evaluated. Studies that met the inclusion criteria were selected. Results The results show that oral and maxillofacial malignancies diagnosed at an early stages （stages Ⅰ and Ⅱ） can be well treated with surgery alone and/or radiotherapy with optimal outcome, but advanced or recurrent diseases should be treated with rational combined and sequential treatment modalities. The use of concomitant chemoradiotherapy, taxane-containing, three-drug induction regimens and Cetuximab in combination with chemotherapy or radiotherapy demonstrated favorable results in previously untreated patients with head and neck squamous cell carcinoma. Conclusions The concept of combined and sequential treatment of advanced oral and maxillofacial malignancies should be widely accepted, and the rational regimen for individual and each type of entity should be determined based on the anatomical site and the patient＇s performance status.展开更多
文摘Oral and maxillofacial malignancies still remain significant health problems worldwide, the 5- year relativesurvival rate was 47.7% for oral squamous cell carcinoma and 64.7% for carcinomas of the major salivary glands accordingto NCDB reports. Successful management of these malignancies now requires a cooperative or multidisciplinary approachstrongly evidence based, ordered, even individualized rather than randomized, among a broad group of medical disciplinesincluding head and neck surgery, radiation oncology, medical oncology, medical imaging, clinical pathology and labmedicine, social work, nutrition, and others. Different treatment modalities are mandatory for different primary sites,histopathologic types, different TNM stages and different patients, either dominated by surgery, radiation therapy orchemotherapy, coordinated other modalities. This paper evaluated and summarized current comprehensive and sequentialapproaches to the management of oral and maxillofacial malignancies, emphasizing the importance of multidisciplinaryteam approach to coordinate surgery, radiation therapy and chemotherapy. The roles of induction chemotherapy andconcomitant chemoradiotherapy were also discussed. Comprehensive strategies for different oral and maxillofacialmalignancies had been proposed by National Comprehensive Cancer Network (NCCN) and introduced to the Chinesecolleagues for clinical references. The future lies in the development of individualized treatment regimes that combineearly detection with organ preservation and result in improved cure rates and quality of life, study of the best treatmentorder of the three disciplines of surgery, radiation, and chemotherapy; the refinement of radiation by altering fraction dose,sequence, and time course; radiosensitization by chemo- and biologic therapy; and the addition of novel, biologicallytargeted agents to these disciplines.
文摘Objective To introduce the concept and rational regimens and present the latest development of combined treatment of oral and maxillofacial malignancies. Data sources The related published literature was searched through the CNKI database and MEDLINE using the terms of oral cancer, oral and maxillofacial malignancies, combined and sequential therapy, multidisciplinary approach. Study selection The available related literature was read and evaluated. Studies that met the inclusion criteria were selected. Results The results show that oral and maxillofacial malignancies diagnosed at an early stages （stages Ⅰ and Ⅱ） can be well treated with surgery alone and/or radiotherapy with optimal outcome, but advanced or recurrent diseases should be treated with rational combined and sequential treatment modalities. The use of concomitant chemoradiotherapy, taxane-containing, three-drug induction regimens and Cetuximab in combination with chemotherapy or radiotherapy demonstrated favorable results in previously untreated patients with head and neck squamous cell carcinoma. Conclusions The concept of combined and sequential treatment of advanced oral and maxillofacial malignancies should be widely accepted, and the rational regimen for individual and each type of entity should be determined based on the anatomical site and the patient＇s performance status.
