Cancer of the oral mucosa (cancer of the tongue, floor of mouth, lower jaw, cheek)/lip: modern therapeutic technologies

Abstract

Purpose. Evaluation of the effectiveness of three treatment options for cancer oral mucosa (cancer of the tongue and floor of mouth, cheek, lower jaw)/lip (OC/lip). Materials and methods. Treated 100 patients with OC/lip: combined treatment with surgery at the first stage and postoperative conformal external beam radiation therapy (EBRT) of 50 Gy — 40 patients; combined conformal EBRT and brachytherapy (BT HDR) — 40 patients; EBRT and photodynamic therapy (PDT) with intensive laser hyperthermia — 20 patients. The age of the patients ranged from 26 to 90 years; among them were 55 men and 45 women. Results. Five-year overall survival (OS) and relapse-free survival (RFS) in patients with tumors of various localization was 88% and 73.3% respectively with a good quality of life. Five-year OS was for combined method of treatment — 82,8%; combined EBRT and brachytherapy — 94,4% and EBRT in combination with PDT and laser hyperthermia — 83,3% (р=0,561). With tumors of stage I–II, the five-year OS was 94.4% and III–IV stage — decreased to 73.1% with a high level of statistical significance of the χ²=6.042, p=0.014. Conclusions. OC and lip cancer is most effectively cured in the I–II stage of the disease with the initial implementation of the surgical stage preceding EBRT. EBRT with photodynamic therapy and laser hyperthermia is effective for contraindications for patients to brachytherapy. The determination of PM (predictive markers) is a promising direction in optimizing the antitumor treatment of malignant neoplasms of OC/lip.