The Modern Concept of Using Radiation Therapy for Cancer of the Oral Cavity and the Oropharyngeal Area

Abstract

In the world, there is a rise of cancer incidence, including cancer of the head and neck. The incidence cancer of the head and neck is 4.8 cases per 100 000 population. Oral and oropharyngeal cancers are the most frequently forms cancer of the head and neck – 4,8–27 % of all cancer with this location. Among the causes of oral and oropharyngeal cancer noted alcohol abuse, tobacco and infection with human papilloma virus (HPV-16). Mortality from oral and oropharyngeal cancer is on 8 rank among patients with all tumors. Now when deciding about treatment of oral and oropharyngeal cancer is applied a new classification АJCC8th, the main differences from the previous version are the inclusion of data on the depth of tumor invasion and the presence of extranodal growth of lymphogenic metastasis. The chemoradiotherapy to a total dose 60–74 Gy is the most common treatment used in oral and oropharyngeal cancer. When planning irradiation, both the tumor itself (or its residual component) and lymphogenic metastases or lymph nodes with a high risk of metastatic lesions are included in the target volume. The most commonly used chemotherapy drug is cisplatin. The duration of life of patients is significantly influenced by the stage of the tumor process. So 5-year relapse-free survival among patients with oral cancer is 91 % at T1–2, 83 % – at T3 and 12 % – at T4. During the first 5 years after completion of treatment, the probability of locoregional recurrence in patients with oropharyngeal cancer is much shorter in infected HPV-16 – 28.9 % and 54.9 %, respectively. The effective multimodal treatment of oral and oropharyngeal cancer can be only if the evaluation of the tumor process under the current classification, comply with the requirements of treatment standards and clinical guidelines as well as take into account the latest achievements of the relevant field of medical science.