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    Lip and Oral Cavity Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage III Lip and Oral Cavity Cancer

    continued...

    Standard treatment options:

    1. Surgery using rim resection plus neck dissection or partial mandibulectomy with neck dissection, as appropriate.
    2. Radiation therapy using EBRT alone or EBRT plus an interstitial implant.

    Treatment options under clinical evaluation:

    1. Clinical trials for advanced tumors evaluating the use of chemotherapy preoperatively, before radiation therapy, as adjuvant therapy after surgery, or as part of combined modality therapy are appropriate.[3,4,5,6,8,9,10,12]
    2. Clinical trials using novel radiation therapy fractionation schemas.[13]

    Moderately Advanced Lesions of the Lower Gingiva

    Standard treatment options:

    • Combined radiation therapy and radical resection or radical resection alone are used to treat extensive lesions with moderate bone destruction and/or nodal metastases; radiation therapy may be administered either preoperatively or postoperatively.

    Advanced Lesions of the Retromolar Trigone

    Standard treatment options:

    • Surgical composite resection that may be followed by postoperative radiation therapy.

    Treatment options under clinical evaluation:

    1. Clinical trials for advanced tumors evaluating the use of chemotherapy preoperatively, before radiation therapy, as adjuvant therapy after surgery, or as part of combined modality therapy are appropriate.[3,4,5,6,8,9,10,12]
    2. Clinical trials using novel radiation therapy fractionation schemas.[13]

    Moderately Advanced Lesions of the Upper Gingiva

    Standard treatment options:

    1. Radiation therapy alone is used to treat superficial lesions with extensive involvement of the gingiva, hard palate, or soft palate.
    2. A combination of surgery and radiation therapy is used to treat deeply invasive lesions involving bone.

    Moderately Advanced Lesions of the Hard Palate

    Standard treatment options:

    1. Radiation therapy alone is used to treat superficial lesions with extensive involvement of the gingiva, hard palate, or soft palate.
    2. A combination of surgery and radiation therapy or surgery alone is used to treat deeply invasive lesions involving bone.

    Treatment options for management of lymph nodes:[1]

    • Patients with advanced lesions should have elective lymph node radiation therapy or node dissection. The risk of metastases to lymph nodes is increased by high-grade histology, large lesions, spread to involve the wet mucosa of the lip or the buccal mucosa in patients with recurrent disease, and invasion of muscle (i.e., orbicularis oris).
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