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

Surgery and/or radiation therapy may be used, depending on the exact site.[1]

Small Lesions of the Lip

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Standard treatment options: Palliative chemotherapy with: Fluorouracil (5-FU).[1,2,3]Epirubicin, cisplatin, and 5-FU (ECF).[4,5]Epirubicin, oxaliplatin, and capecitabine (EOX).[6]Cisplatin and 5-FU (CF).[7,3]Docetaxel, cisplatin, and 5-FU.[8]Etoposide, leucovorin, and 5-FU (ELF).[9]5-FU, doxorubicin, and methotrexate (FAMTX).[7] Trastuzumab, cisplatin, and either 5-FU or capecitabine in patients with HER2-positive tumors (3+ on immunohistochemistry [IHC] or fluorescence in situ...

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Standard treatment options:

  1. Surgery is used for patients with smaller T2 lesions on the lower lip, if simple closure produces an acceptable cosmetic result.
  2. Radiation therapy, which may include external-beam and/or interstitial techniques, as appropriate, has the advantage of producing a relatively better functional and cosmetic result with intact skin and muscle innervation, if a reconstructive surgical procedure is required.

Small Anterior Tongue Lesions

Standard treatment options:

  1. Radiation therapy is usually selected for patients with T2 lesions that have minimal infiltration to preserve speech and swallowing. [2]
  2. Surgery is reserved for patients for whom radiation treatment failed.[2]
  3. Neck dissection may be considered when primary brachytherapy is used.[2]
  4. Surgery, radiation therapy, or a combination of both are used for deeply infiltrative lesions.

Small Lesions of the Buccal Mucosa

Standard treatment options:

  1. Radiation therapy is the usual treatment for patients with small T2 lesions (≤3 cm).
  2. Surgery, radiation therapy, or a combination of these are used, if indicated to treat large T2 lesions (>3 cm). Radiation therapy is often used, if the lesion involves the commissure. Surgery is often used, if tumor invades the mandible or maxilla.

Small Lesions of the Floor of the Mouth

Standard treatment options:

  1. Surgery is often used for patients with small T2 lesions (≤3 cm), if the lesion is attached to the periosteum.
  2. Radiation therapy is often used to treat patients with small T2 lesions (≤3 cm), if the lesion encroaches on the tongue.
  3. Surgery and radiation therapy are alternative methods of treatment for patients with large T2 lesions (>3 cm), the choice of which depends primarily on the expected extent of disability from surgery.
  4. External-beam radiation therapy with or without interstitial radiation therapy should be considered postoperatively for larger lesions.

Small Lesions of the Lower Gingiva

Standard treatment options:

  1. Intraoral resection with or without a rim resection of bone and repair with a split-thickness skin graft are used to treat patients with small lesions.
  2. Radiation therapy may be used to treat patients with small lesions, but results are generally better after surgery alone.

Small Tumors of the Retromolar Trigone

Standard treatment options:

  1. Limited resection of the mandible is performed to treat patients with early lesions that are without detectable bone invasion.
  2. Radiation therapy may be used initially, if limited resection is not feasible.
  3. Surgery is reserved for radiation failure.

Small Lesions of the Upper Gingiva and Hard Palate

Standard treatment options:

  • Surgical resection with postoperative radiation therapy, as appropriate, is used to treat most lesions. A small study showed that radiation therapy may be used effectively as the sole treatment modality.[3]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II lip and oral cavity cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

  1. Harrison LB, Sessions RB, Hong WK, eds.: Head and Neck Cancer: A Multidisciplinary Approach. 3rd ed. Philadelphia, PA: Lippincott, William & Wilkins, 2009.
  2. Pernot M, Malissard L, Aletti P, et al.: Iridium-192 brachytherapy in the management of 147 T2N0 oral tongue carcinomas treated with irradiation alone: comparison of two treatment techniques. Radiother Oncol 23 (4): 223-8, 1992.
  3. Yorozu A, Sykes AJ, Slevin NJ: Carcinoma of the hard palate treated with radiotherapy: a retrospective review of 31 cases. Oral Oncol 37 (6): 493-7, 2001.
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WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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