Opinion statement
Oral cancer is the sixth most common cancer in the world, and it continues to represent a serious public health problem. Oral cancer is a preventable disease, related to behavioral and lifestyle factors, including tobacco and alcohol. Prevention and early detection of oral cancer remain the goals of national efforts to reduce the impact of this disease on the public. Surgical treatment is the mainstay of therapy for patients with oral cancer, particularly in advanced stages of cancer. External beam radiation therapy and brachytherapy have been used successfully as the primary modality for treating patients with early stage oral cancer, and they are the standard of care for use as adjuvant therapy in postoperative cases of patients with advanced stage oral cancer. There is an emerging trend for the use of chemotherapy in combination with radiation therapy and surgery for patients with advanced, recurrent, and metastatic head and neck cancer, although evidence is limited regarding survival benefit when used for treating patients with oral cavity carcinoma. Any report on the treatment of oral cancer is incomplete without consideration of functional and aesthetic outcomes, particularly addressing speech, swallowing, masticatory efficiency, and dental rehabilitation. Future generations will continue to fight these dreadful diseases until scientists and clinicians are provided the opportunities to expand efforts to prevent, detect (early), and eradicate oral and other head and neck cancers.
Similar content being viewed by others
References and Recommended Reading
Ries LAG, Eisner MP, Kosary CL, et al.: SEER Cancer Statistics Review, 1973–1999. Bethesda: National Cancer Institute; 2002.
Shiboski CH, Shiboski SC, Silverman S Jr: Trends in oral cancer rates in the United States, 1973–1996? Community Dent Oral Epidemiol 2000, 28:249–256.
Patel V, Leethanakul C, Gutkind JS: New approaches to the understanding of the molecular basis of oral cancer? Crit Rev Oral Biol Med 2001, 12:55–63. An overview of recent advances in the molecular characterization of head and neck cancer, including the use of laser capture microdissection and DNA analysis techniques.
Kim ES, Kies M, Herbst RS: Novel therapeutics for head and neck cancer? Curr Opin Oncol 2002, 14:334–342.
Funk GF, Karnell LH, Robinson RA, et al.: Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report? Head Neck 2002, 24:165–180.
Casiglia J, Woo SB: A comprehensive review of oral cancer? Gen Dent 2001, 49:72–82.
Sisk EA, Zhu S, Fisher SG, et al.: Human papillomavirus and p53 mutational status as prognostic factors in head and neck carcinoma? Head Neck 2002, 24:841–849.
Day GL, Shore RE, Blot WJ, et al.: Dietary factors and second primary cancers: a follow-up of oral and pharyngeal cancer patients? Nutr Cancer 1994, 21:223–232.
Morse DE, Pendrys DG, Katz RV, et al.: Food group intake and the risk of oral epithelial dysplasia in a United States population? Cancer Causes Control 2000, 11:713–720.
Negri E, Franceschi S, Bosetti C, et al.: Selected micronutrients and oral and pharyngeal cancer? Int J Cancer 2000, 86:122–127.
Horowitz AM, Drury TF, Goodman HS, Yellowitz JA: Oral pharyngeal cancer prevention and early detection: dentists’ opinions and practices? J Am Dent Assoc 2000, 131:453–462.
Sciubba JJ: Improving detection of precancerous and cancerous oral lesions: computer-assisted analysis of the brush biopsy. US Collaborative OralCDx Study Group? J Am Dent Assoc 1999, 130:1445–1457.
Onofre MA, Sposto MR, Navarro CM: Reliability of toluidine blue application in the detection of oral epithelial dysplasia and in situ and invasive squamous cell carcinomas? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001, 91:535–540.
Portugal LG, Wilson KM, Biddinger PW, Gluckman JL: The role of toluidine blue in assessing margin status after resection of squamous cell carcinomas of the upper aerodigestive tract? Arch Otolaryngol Head Neck Surg 1996, 122:517–519.
Epstein JB, Oakley C, Millner A, et al.: The utility of toluidine blue application as a diagnostic aid in patients previously treated for oropharyngeal carcinoma? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997, 83:537–547.
Lippman SM, Lee JJ, Karp DD, et al.: Randomized phase III intergroup trial of isotretinoin to prevent second primary tumors in stage I non-small-cell lung cancer? J Natl Cancer Inst 2001, 93:605–618.
Garewal HS, Katz RV, Meyskens F, et al.: Beta-carotene produces sustained remissions in patients with oral leukoplakia: results of a multicenter prospective trial? Arch Otolaryngol Head Neck Surg 1999, 125:1305–1310.
Mellott A, Vokes E: Chemoprevention in head and neck cancer? Cancer Treat Res 2001, 106:221–235.
Braakhuis BJ, Tabor MP, Leemans CR, et al.: Second primary tumors and field cancerization in oral and oropharyngeal cancer: molecular techniques provide new insights and definitions? Head Neck 2002, 24:198–206.
Jang SJ, Chiba I, Hirai A, et al.: Multiple oral squamous epithelial lesions: Are they genetically related? Oncogene 2001, 20:2235–2242.
Califano J, van der Riet P, Westra W, et al.: Genetic progression model for head and neck cancer: implications for field cancerization? Cancer Res 1996, 56:2488–2492.
Boyle JO, Hakim J, Koch W, et al.: The incidence of p53 mutations increases with progression of head and neck cancer? Cancer Res 1993, 53:4477–4480.
Forastiere A, Koch W, Trotti A, Sidransky D: Head and neck cancer? N Engl J Med 2001, 345:1890–1900. Well-organized comprehensive review of head and neck cancer pathogenesis and treatment.
Shintani S, Kiyota A, Mihara M, et al.: Association of preoperative radiation effect with tumor angiogenesis and vascular endothelial growth factor in oral squamous cell carcinoma? Jpn J Cancer Res 2000, 91:1051–1057.
Semenza G: HIF-1 and tumor progression: pathophysiology and therapeutics? Trends Mol Med 2002, 8:S62-S67.
Sudbo J, Kildal W, Risberg B, et al.: DNA content as a prognostic marker in patients with oral leukoplakia? N Engl J Med 2001, 344:1270–1278.
Zhang L, Rosin MP: Loss of heterozygosity: a potential tool in management of oral premalignant lesions? J Oral Pathol Med 2001, 30:513–520.
Greene FL, Page DL, Fleming ID, et al.: Cancer Staging Manual. New York: Springer-Verlag; 2002.
Zieron JO, Lauer I, Remmert S, Sieg P: Single photon emission tomography: scintigraphy in the assessment of mandibular invasion by head and neck cancer? Head Neck 2001, 23:979–984.
Don DM, Anzai Y, Lufkin RB, et al.: Evaluation of cervical lymph node metastases in squamous cell carcinoma of the head and neck? Laryngoscope 1995, 105:669–674.
Robbins KT, Clayman G, Levine PA, et al.: Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery? Arch Otolaryngol Head Neck Surg 2002, 128:751–758.
Mukherji SK, Castelijns J, Castillo M: Squamous cell carcinoma of the oropharynx and oral cavity: how imaging makes a difference? Semin Ultrasound CT MR 1998, 19:463–475.
Mukherji SK, Isaacs DL, Creager A, et al.: CT detection of mandibular invasion by squamous cell carcinoma of the oral cavity? AJR Am J Roentgenol 2001, 177:237–243. The use of CT scanning in assessing mandibular involvement, thus staging of oral cancer is well described in this article.
Shaha AR: Preoperative evaluation of the mandible in patients with carcinoma of the floor of mouth? Head Neck 1991, 24:398–402.
Weber AL, Scrivani SJ: Mandible: anatomy, cysts, tumors, and non-tumorous lesions. In Head and Neck Imaging. Edited by Som CH. St. Louis: Mosby; 1996:320–323.
Nakasone Y, Inoue T, Oriuchi N, et al.: The role of whole-body FDG-PET in preoperative assessment of tumor staging in oral cancers? Ann Nucl Med 2001, 15:505–512.
Mukherji SK, Drane WE, Mancuso AA, et al.: Occult primary tumors of the head and neck: detection with 2-[F-18] fluoro-2-deoxy-D-glucose SPECT? Radiology 1996, 199:761–766.
Anzai Y, Carroll WR, Quint DJ, et al.: Recurrence of head and neck cancer after surgery or irradiation: prospective comparison of 2-deoxy-2-[F-18]fluoro-Dglucose PET and MR imaging diagnoses? Radiology 1996, 200:135–141.
Stoeckli SJ, Steinert H, Pfaltz M, Schmid S: Is there a role for positron emission tomography with 18F-fluorodeoxyglucose in the initial staging of nodal negative oral and oropharyngeal squamous cell carcinoma? Head Neck 2002, 24:345–349.
Neville B, Day T: Oral cancer and precancerous lesions? CA Cancer J Clin 2002, 32:195–215.
Pindborg JJ, Renstrup G, Poulsen HE, et al.: Studies in oral leukoplakia - V. Clinical and histologic signs of malignancy? Acta Odontol Scand 1963, 21:407–414.
Silverman S Jr, Gorsky M, Lozada F: Oral leukoplakia and malignant transformation: a follow-up study of 257 patients? Cancer 1984, 53:563–568.
Silverman S Jr, Gorsky M: Proliferative verrucous leukoplakia: a follow-up study of 54 cases? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997, 84:154–157.
Shafer WG, Waldron CA: Erythroplakia of the oral cavity? Cancer 1975, 36:1021–1028.
Russolo M, Giacomarra V, Papanikolla L, Tirelli G: Prognostic indicators of occult metastases in oral cancer? Laryngoscope 2002, 112:1320–1323.
Yuen A, Lam KY, Wei WI, et al.: A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathologic features of oral tongue carcinoma? Am J Surg 2000, 180:139–143. Supports the concept of tumor thickness as an important prognostic indicator in consideration of adjuvant therapy for tongue cancer.
Bundgaard T, Bentzen SM, Wildt J, et al.: Histopathologic, stereologic, epidemiologic, and clinical parameters in the prognostic evaluation of squamous cell carcinoma of the oral cavity? Head Neck 1996, 18:142–152.
Gluckman JL, Pavelic ZP, Welkoborsky HJ, et al.: Prognostic indicators for squamous cell carcinoma of the oral cavity: a clinicopathologic correlation? Laryngoscope 1997, 107:1239–1244.
Hicks WL Jr, Loree TR, Garcia RI, et al.: Squamous cell carcinoma of the floor of mouth: a 20-year review? Head Neck 1997, 19:400–405. One of the largest reviews of patients with floor-of-mouth cancer, with an emphasis on surgical treatment results and locoregional control rates.
Cooley ML, Hoffman HT, Robinson RA: Discrepancies in frozen section mucosal margin tissue in laryngeal squamous cell carcinoma? Head Neck 2002, 24:262–267.
Johnson RE, Sigman JD, Funk GF, et al.: Quantification of surgical margin shrinkage in the oral cavity? Head Neck 1997, 19:281–286.
Smeele LE, Leemans CR, Langendijk JA, et al.: Positive surgical margins in neck dissection specimens in patients with head and neck squamous cell carcinoma and the effect of radiotherapy? Head Neck 2000, 22:559–563.
Hiratsuka H, Miyakawa A, Nakamori K, et al.: Multivariate analysis of occult lymph node metastasis as a prognostic indicator for patients with squamous cell carcinoma of the oral cavity? Cancer 1997, 80:351–356.
Looser KG, Shah JP, Strong EW: The significance of “positive” margins in surgically resected epidermoid carcinomas? Head Neck Surg 1978, 1:107–111.
Parsons JT, Mendenhall WM, Stringer SP, et al.: An analysis of factors influencing the outcome of postoperative irradiation for squamous cell carcinoma of the oral cavity? Int J Radiat Oncol Biol Phys 1997, 39:137–148. Consideration of indications and approach to radiation therapy in the postoperative setting often includes criteria, which have been better defined by this study.
Spiro RH, Huvos AG, Wong GY, et al.: Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth? Am J Surg 1986, 152:345–350.
Ord RA, Aisner S: Accuracy of frozen sections in assessing margins in oral cancer resection? J Oral Maxillofac Surg 1997, 55:663–669.
Loree TR, Strong EW: Significance of positive margins in oral cavity squamous carcinoma? Am J Surg 1990, 160:410–414.
Partridge M, Li SR, Pateromichelakis S, et al.: Detection of minimal residual cancer to investigate why oral tumors recur despite seemingly adequate treatment? Clin Cancer Res 2000, 6:2718–2725.
Mazeron JJ, Grimard L, Raynal M, et al.: Iridium-192 curietherapy for T1 and T2 epidermoid carcinomas of the floor of mouth? Int J Radiat Oncol Biol Phys 1990, 18:1299–1306.
Cole D, Patel P, Matar J: Floor of mouth cancer? Arch Otolaryngol Head Neck Surg 1994, 120:260–263.
Spiro RH, Strong EW: Epidermoid carcinoma of the mobile tongue: treatment by partial glossectomy alone? Am J Surg 1971, 122:707–710.
O’Brien CJ, Lahr CJ, Soong SJ, et al.: Surgical treatment of early-stage carcinoma of the oral tongue-would adjuvant treatment be beneficial? Head Neck Surg 1986, 8:401–408.
Zelefsky MJ, Harrison LB, Fass DE, et al.: Postoperative radiotherapy for oral cavity cancers: impact of anatomic subsite on treatment outcome? Head Neck 1990, 12:470–475.
Lindberg R: Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts? Cancer 1972, 29:1446–1449. A classic description of the lymphatic spread of head and neck cancer.
Shah JP: Cervical lymph node metastases: diagnostic, therapeutic, and prognostic implications? Oncology (Huntingt) 1990, 4:61–69.
Kowalski LP: Results of salvage treatment of the neck in patients with oral cancer? Arch Otolaryngol Head Neck Surg 2002, 128:58–62.
Hughes CJ, Gallo O, Spiro RH, Shah JP: Management of occult neck metastases in oral cavity squamous carcinoma? Am J Surg 1993, 166:380–383. A study showing that the level of lymph node metastases is an important prognostic indicator in patients with oral cancer.
Kowalski LP, Bagietto R, Lara JR, et al.: Prognostic significance of the distribution of neck node metastasis from oral carcinoma? Head Neck 2000, 22:207–214.
Spiro JD, Spiro RH, Shah JP, et al.: Critical assessment of supraomohyoid neck dissection? Am J Surg 1988, 156:286–289.
Byers RM, Weber RS, Andrews T, et al.: Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue? Head Neck 1997, 19:14–19. The results of this report should be considered in the evaluation and management of patients diagnosed with tongue cancer.
O’Brien CJ, Traynor SJ, McNeil E, et al.: The use of clinical criteria alone in the management of the clinically negative neck among patients with squamous cell carcinoma of the oral cavity and oropharynx? Arch Otolaryngol Head Neck Surg 2000, 126:360–365.
Clayman GL, Frank DK: Selective neck dissection of anatomically appropriate levels is as efficacious as modified radical neck dissection for elective treatment of the clinically negative neck in patients with squamous cell carcinoma of the upper respiratory and digestive tracts? Arch Otolaryngol Head Neck Surg 1998, 124:348–352. This article provides additional evidence of the use of selective neck dissection as an alternative to more comprehensive procedures in the management of head and neck cancer.
Ambrosch P, Freudenberg L, Kron M, Steiner W: Selective neck dissection in the management of squamous cell carcinoma of the upper digestive tract? Eur Arch Otorhinolaryngol 1996, 253:329–335.
Woolgar JA: Histological distribution of cervical lymph node metastases from intraoral/oropharyngeal squamous cell carcinomas? Br J Oral Maxillofac Surg 1999, 37:175–180.
Koch WM, Choti MA, Civelek AC, et al.: Gamma probedirected biopsy of the sentinel node in oral squamous cell carcinoma? Arch Otolaryngol Head Neck Surg 1998, 124:455–459.
Wendt CD, Peters LJ, Delclos L, et al.: Primary radiotherapy in the treatment of stage I and II oral tongue cancers: importance of the proportion of therapy delivered with interstitial therapy? Int J Radiat Oncol Biol Phys 1990, 18:1287–1292.
Fu KK, Pajak TF, Trotti A, et al.: Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003? Int J Radiat Oncol Biol Phys 2000, 48:7–16. An in-depth look at the various radiation techniques and early results in patients with head and neck cancers.
Ang KK: Altered fractionation trials in head and neck cancer? Semin Radiat Oncol 1998, 8:230–236.
Adelstein DJ, Saxton JP, Lavertu P, et al.: Maximizing local control and organ preservation in stage IV squamous cell head and neck cancer with hyperfractionated radiation and concurrent chemotherapy? J Clin Oncol 2001, 20:1405–1410.
Calais G, Alfonsi M, Bardet E, et al.: Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma? J Natl Cancer Inst 1999, 91:2081–2086. This study provides convincing data in support of the use of concomitant chemotherapy and radiation therapy in patients with oropharyngeal cancer.
Forastiere AA, Trotti A: Radiotherapy and concurrent chemotherapy: a strategy that improves locoregional control and survival in oropharyngeal cancer? J Natl Cancer Inst 1999, 91:2065–2066.
Beitler JJ, Smith RV, Silver CE, et al.: Close or positive margins after surgical resection for the head and neck cancer patient: the addition of brachytherapy improves local control? Int J Radiat Oncol Biol Phys 1998, 40:313–317.
Chao KS, Majhail N, Huang CJ, et al.: Intensity-modulated radiation therapy reduces late salivary toxicity without compromising tumor control in patients with oropharyngeal carcinoma: a comparison with conventional techniques? Radiother Oncol 2001, 61:275–280. With an emerging trend toward salivary protection and toxicity reduction, IMRT may provide benefit without a decrease in locoregional control.
Brizel DM, Wasserman TH, Henke M, et al.: Phase III randomized trial of amifostine as a radioprotector in head and neck cancer? J Clin Oncol 2000, 18:3339–3345. Toxicity reduction in head and neck radiation often includes xerostomia, which is significantly reduced through intravenous use of amifostine in this study.
Horiot JC, Lipinski F, Schraub S, et al.: Post-radiation severe xerostomia relieved by pilocarpine: a prospective French cooperative study? Radiother Oncol 2000, 55:233–239.
Petrovich Z, Parker RG, Luxton G, et al.: Carcinoma of the lip and selected sites of head and neck skin: a clinical study of 896 patients? Radiother Oncol 1987, 8:11–17.
Mazeron JJ, Crook JM, Benck V, et al.: Iridium 192 implantation of T1 and T2 carcinomas of the mobile tongue? Int J Radiat Oncol Biol Phys 1990, 19:1369–1376.
Mazeron JJ, Crook JM, Marinello G, et al.: Prognostic factors of local outcome for T1, T2 carcinomas of oral tongue treated by iridium 192 implantation? Int J Radiat Oncol Biol Phys 1990, 19:281–285.
Laramore GE, Scott CB, al-Sarraf M, et al.: Adjuvant chemotherapy for resectable squamous cell carcinoma of the head and neck: report on Intergroup Study 0034? Int J Radiat Oncol Biol Phys 1992, 23:705–713.
Cooper JS, Pajak TF, Forastiere A, et al.: Precisely defining high-risk operable head and neck tumors based on RTOG #85-03 and #88-24: targets for postoperative radiochemotherapy? Head Neck 1998, 20:588–594. This paper presents evidence-based prognostic factors for recurrence after head and neck cancer surgery that may serve as criteria for trials of adjuvant therapy.
Bourhis J, Calais G, Eschwege F: Chemoradiotherapy of carcinomas of the upper aerodigestive tract? Cancer Radiother 1998, 2:679–688.
Lefebvre JL, Chevalier D, Luboinski B, et al.: Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group? J Natl Cancer Inst 1996, 88:890–899.
Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The Department of Verterans Affairs Laryngeal Cancer Study Group. N Engl J Med 1991, 324:1685–1690.
Brizel DM, Albers ME, Fisher SR, et al.: Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer? N Engl J Med 1998, 338:1798–1804.
Vokes EE, Kies MS, Haraf DJ, et al.: Concomitant chemoradiotherapy as primary therapy for locoregionally advanced head and neck cancer? J Clin Oncol 2000, 18:1652–1661. This study examines the treatment results and potential for adjuvant surgical treatment in patients treated primarily with concomitant chemotherapy and radiation therapy.
Adelstein DJ, Lavertu P, Saxton JP, et al.: Mature results of a phase III randomized trial comparing concurrent chemoradiotherapy with radiation therapy alone in patients with stage III and IV squamous cell carcinoma of the head and neck? Cancer 2000, 88:876–883. Additional evidence of the use of concurrent chemotherapy and radiation therapy in patients with advanced head and neck cancers from a large multi-institutional trial.
Lamont EB, Vokes EE: Chemotherapy in the management of squamous-cell carcinoma of the head and neck? Lancet Oncol 2001, 2:261–269.
Forastiere AA: Chemotherapy of head and neck cancer? Ann Oncol 1992, 3(Suppl 3):11–14.
Khuri FR, Nemunaitis J, Ganly I, et al.: A controlled trial of intratumoral ONYX-015, a selectively-replicating adenovirus, in combination with cisplatin and 5-fluorouracil in patients with recurrent head and neck cancer? Nat Med 2000, 6:879–885.
Beumer J III, Marunick M, Roumanos E, et al.: Restoration of facial defects: etiology, disability, and rehabilitation. In Maxillofacial Rehabilitation: Prosthodontic and Surgical Considerations, CT. Edited by Beumer J III, Curtis TA, Marunick M. St. Louis: Ishijaku Euro America; 1996:337–453.
Marunick MT, Mathes BE, Klein BB: Masticatory function in hemimandibulectomy patients? J Oral Rehabil 1992, 19:289–295.
Urken ML, Buchbinder D, Weinberg H, et al.: Functional evaluation following microvascular oromandibular reconstruction of the oral cancer patient: a comparative study of reconstructed and nonreconstructed patients? Laryngoscope 1991, 101:935–950.
Lazarus CL, Logemann JA, Pauloski BR, et al.: Swallowing and tongue function following treatment for oral and oropharyngeal cancer? J Speech Lang Hear Res 2000, 43:1011–1023.
Hamlet S, Jones L, Mathog R, et al.: Bolus propulsive activity of the tongue in dysphagic cancer patients? Dysphagia 1988, 3:18–23.
Logemann JA, Pauloski BR, Rademaker AW, et al.: Speech and swallow function after tonsil/base of tongue resection with primary closure? J Speech Hear Res 1993, 36:918–926.
Pauloski BR, Logemann JA, Rademaker AW, et al.: Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction? J Speech Hear Res 1993, 36:267–276.
Pauloski BR, Logemann JA, Rademaker AW, et al.: Speech and swallowing function after oral and oropharyngeal resections: one-year follow-up? Head Neck 1994, 16:313–322.
Hirsch SM, Caldarelli DD, Hutchinson JC Jr, et al.: Concomitant chemotherapy and split-course radiation for cure and preservation of speech and swallowing in head and neck cancer? Laryngoscope 1991, 101:583–586.
Martin BJ, Logemann JA, Shaker R, Dodds WJ: Coordination between respiration and swallowing: respiratory phase relationships and temporal integration? J Appl Physiol 1994, 76:714–723.
Zitsch RP 3rd, Todd DW, Renner GJ, Singh A: Intraoperative radiolymphoscintigraphy for detection of occult nodal metastasis in patients with head and neck squamous cell carcinoma? Otolaryngol Head Neck Surg 2000, 122:662–666. Although commonly used in melanoma, few studies have evaluated the application of sentinel lymph node biopsy in SCC. This report provides early results and insight into its use in head and neck cancer.
Vokes EE, Haraf DJ, Brockstein BE, Weichselbaum RR: Paclitaxel, 5-fluorouracil, hydroxyurea, and concomitant radiation therapy for poor-prognosis head and neck cancer? Semin Radiat Oncol 1999, 9:70–76.
Clayman GL, el-Naggar AK, Lippman SM, et al.: Adenovirus-mediated p53 gene transfer in patients with advanced recurrent head and neck squamous cell carcinomas? J Clin Oncol 1998, 16:2221–2232.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Day, T.A., Davis, B.K., Gillespie, M.B. et al. Oral cancer treatment. Curr. Treat. Options in Oncol. 4, 27–41 (2003). https://doi.org/10.1007/s11864-003-0029-4
Issue Date:
DOI: https://doi.org/10.1007/s11864-003-0029-4