摘要
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.
Oral and maxillofacial malignancies still remain significant health problems worldwide, the 5-year relative survival rate was 47.7% for oral squamous cell carcinoma and 64.7% for carcinomas of the major salivary glands according to NCDB reports. Successful management of these malignancies now requires a cooperative or multidisciplinary approach strongly evidence based, ordered, even individualized rather than randomized, among a broad group of medical disciplines including head and neck surgery., radiation oncology, medical oncology, medical imaging, clinical pathology and lab medicine, 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 or chemotherapy, coordinated other modalities. This paper evaluated and summarized current comprehensive and sequential approaches to the management of oral and maxillofacial malignancies, emphasizing the importance of multidisciplinary team approach to coordinate surgery, radiation therapy and chemotherapy. The roles of induction chemotherapy and concomitant chemoradiotherapy were also discussed. Comprehensive strategies for different oral and maxillofacial malignancies had been proposed by National Comprehensive Cancer Network （NCCN） and introduced to the Chinese colleagues for clinical references. The future lies in the development of individualized treatment regimes that combine early detection with organ preservation and result in improved cure rates and quality of life, study of the best treatment order 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, biologically targeted agents to these disciplines.
出处
《中国口腔颌面外科杂志》
CAS
2005年第3期179-182,共4页
China Journal of Oral and Maxillofacial Surgery
