Recurrent Lip and Oral Cavity Cancer

For lesions of the lip, anterior tongue, buccal mucosa, floor of the mouth, retromolar trigone, upper gingiva, and hard palate, treatment will be dictated by the location and size of the recurrent lesion as well as prior treatment.[1,2]

Standard treatment options:

1. Surgery is the preferred treatment, if radiation therapy was used initially.[3]
2. Surgery,[3] radiation therapy, or a combination of these may be considered for treatment, if surgery was used to treat the lesion initially.
3. Although chemotherapy has been shown to induce responses, no increase in survival has been demonstrated.[4]

Treatment options under clinical evaluation:

• Clinical trials evaluating new chemotherapy drugs, chemotherapy and re-irradiation, or hyperthermia should be considered because surgical salvage after primary treatment by radiation therapy and radiation therapy after primary surgery give poor results.[5,6]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent lip and oral cavity cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

1. Harrison LB, Sessions RB, Hong WK, eds.: Head and Neck Cancer: A Multidisciplinary Approach. Philadelphia, Pa: Lippincott-Raven, 1999.
2. Vikram B, Strong EW, Shah JP, et al.: Intraoperative radiotherapy in patients with recurrent head and neck cancer. Am J Surg 150 (4): 485-7, 1985.
3. Wong LY, Wei WI, Lam LK, et al.: Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery. Head Neck 25 (11): 953-9, 2003.
4. Jacobs C, Lyman G, Velez-García E, et al.: A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol 10 (2): 257-63, 1992.
5. Hong WK, Bromer R: Chemotherapy in head and neck cancer. N Engl J Med 308 (2): 75-9, 1983.
6. Vokes EE, Athanasiadis I: Chemotherapy of squamous cell carcinoma of head and neck: the future is now. Ann Oncol 7 (1): 15-29, 1996.