Patients with oral cavity cancers often present late to seek medical care. Surgery is usually the preferred upfront treatment. However, surgical resection cannot be achieved in many cases with advanced disease without major impact on patient's quality of life. On the other hand, radiotherapy (RT) and chemotherapy (CT) have not been employed routinely to replace surgery as curative treatment or to facilitate surgery as neoadjuvant therapy. The optimal care of these patients is challenging when surgical treatment is not feasible. In this review, we aimed to summarize the best available evidence-based treatment approaches for patients with locally advanced oral cavity cancer. Surgery followed by RT with or without CT is the standard of care for locally advanced oral cavity squamous cell carcinoma. In the case of unresectable disease, induction CT prior to surgery or chemoradiotherapy (CRT) can be attempted with curative intent. For inoperable patients or when surgery is expected to result in poor functional outcome, patients may be candidates for possibly curative CRT or palliative RT with a focus on quality of life.

中文翻译：

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局部晚期口腔癌：什么是最佳护理？

口腔癌患者通常会迟到就医。手术通常是首选的前期治疗。但是，在许多晚期疾病的情况下，如果不对患者的生活质量产生重大影响，就无法实现手术切除。另一方面，放疗（RT）和化学疗法（CT）尚未常规用于代替手术作为治愈性疗法或促进手术作为新辅助疗法。当手术治疗不可行时，这些患者的最佳护理具有挑战性。在这篇综述中，我们旨在总结针对局部晚期口腔癌患者的最佳可用循证治疗方法。伴有或不伴有CT的RT手术是局部晚期口腔鳞状细胞癌的治疗标准。如果是无法切除的疾病，可以尝试根治性手术尝试在外科手术或化学放疗（CRT）之前进行CT诱导。对于不能手术的患者或预期手术会导致较差的功能结局的患者，患者可能是可能治愈性CRT或姑息性RT的候选者，重点是生活质量。