MALIGNANT TUMORS OF THE ORAL CAVITY
Management of the oral cavity may arise from a variety ot tissues, such as salivary gland, muscle, and blood vessels, or may even present as metastases from distant sites, I( sl common, however, are epidermoid carcinomas ot
he oral mucosa.
Treatment Modalities for Malignancies
Malignancies of the oral cavity are treated with surgery, radiation, chemotherapy, or a combination of these modalities, The treatment forany given case depends on several factors, including the histopathologic diagnosis, the 10Ciltion of the tumor, the presence and degree of metastasis, the radio sensitivity or chemosensitivity of the tumor, the age and genera) physical condition of the patient. ‘the cxperience of the treating clinicians, and the wishes of the
patient. In general, if a lesion can be completely excised without rnutilatmg Hie patient.ithis is the preferred modality. If spread to regional lymph nodes is suspected, radiation , may be used before or after surgery to help eliminate small foci of malignant cells in the adjacent areas: If widespread
svstcmic metas asis is detected or if a tumor, such as a Iyrnphorria, is especially chemosensitive, chemotherapv is used with or without surgery and radiation.
Fractionation of the delivery of radiation means that instead of giving the maximal amount of radiation a r,’rson can withstand at one time; smaller increments 01 radiation (i.e., fractions), are given over several week r
which allows the healthier normal tissues ti me to recover between closes, The tumor cells, however, arc less able: to recover between doses, The other delivery method uses multiple ports for radiation exposure. Instead of delivering the entire -dose through one beam (i.e., port), multiple
beams are used. All beams are focused on the tumor but from different angles. Thus the tumor is exposed to the entire dose of radiation. However, because different beams are used, the normal tissues in the path of the
x-ray beams arc spared maximal exposure and instead receive only a fractiorrof -the tumor dose.
Malignancies of the oral cavity that have either suspected or proven lymph node involvement are candidates for composite resection in which the lesion, sur- .rounding tissues, and lymph nodes of the neck’ are totally
removed. This procedure may produce large defects of the jaws and extensive loss of soft tissues, which make functional and esthetic rehabilitation a long, involved process.