口腔颌面部恶性肿瘤治疗指南

The protocol of treatment guideline for oral and maxillofacial malignant neoplasms

口腔颌面部恶性肿瘤约占全身恶性肿瘤的3%～5%,其组织病理学类型多样,以鳞状细胞癌最多见,约占90%以上。由于解剖部位特殊,口腔颌面部恶性肿瘤不仅影响外观,而且造成咀嚼、吞咽、呼吸和语音等功能障碍,严重降低患者的生存质量,并危及生命。手术、放疗和化疗是口腔颌面部恶性肿瘤的三大治疗手段,免疫治疗、生物治疗对某些类型的肿瘤和晚期患者是必要的补充和辅助措施。早期患者以手术治疗为主,晚期患者则提倡综合序列治疗,并鼓励患者参加临床试验。口腔颌面部恶性肿瘤患者的5年总存活率在65%左右,晚期患者的5年存活率不足30%。为了规范口腔颌面部恶性肿瘤的治疗,进一步提高患者的远期存活率,中华口腔医学会口腔颌面外科专业委员会肿瘤学组牵头,组织国内从事口腔颌面部恶性肿瘤治疗的知名专家,参考国内外文献,尤其是2009年美国国立综合癌症网络(NCCN)制订的指南中的相关内容,撰写了《口腔颌面部恶性肿瘤治疗指南》,希望对口腔颌面部恶性肿瘤的规范治疗起到指导作用。随着医学科学技术的发展,新的技术、方法、药物会不断出现,本指南将及时予以更新,以反映和纳入最新的研究成果,为广大患者提供最新的治疗方案。

Oral and maxillofacial malignant neoplasms account for 3%-5% of all malignant tumors,and over 90% of them are squamous cell carcinoma,although the histopathological types are various.Because of the specific anatomical locations,oral and maxillofacial malignancies not only destroy the figures,but also result in severe impairment of mastication,swallowing,respiration and speech,decrease the quality of life,or even lead to death.Surgery,radiotherapy and chemotherapy are the mainstay of treatment for oral and maxillofacial malignancies.Immunotherapy and biotherapy are necessary adjunction in some selected cases and advanced patients.Surgery is the preferred treatment modality for patients at early stage,while combined sequential therapy should be applied to advanced patients,and clinical trials should be encouraged for advanced patients.The overall 5-year survival rate of oral and maxillofacial malignancies is around 65%,but less than 30% for advanced patients.A protocol of treatment guideline for oral and maxillofacial malignant neoplasms was established by experts engaging in diagnosis and treatment of oral and maxillofacial malignancies under the guidance of Division of Oral and Maxillofacial Oncology,Chinese Society of Oral and Maxillofacial Surgery.This protocol is based on the Chinese experiences with reference to 2009 NCCN clinical practice guidelines in oncology.The purpose is to provide a criteria for the management of oral and maxillofacial malignancies and improve the long-term survival of the patients.With the rapid progress of science and technology,new methods,new drugs and new techniques are emerging.This protocol will be renewed and updated to include and reflect the cutting edge knowledge,and provide newest treatment modalities to benefit our patients.