Small Lesions of the Lip
Small Anterior Tongue Lesions
Small Lesions of the Buccal Mucosa
Small Lesions of the Floor of the Mouth
Small Lesions of the Lower Gingiva
Small Tumors of the Retromolar Trigone
Small Lesions of the Upper Gingiva and Hard Palate
Current Clinical Trials

Surgery and/or radiation therapy may be used, depending on the exact site.[1]

Standard treatment options:

1. Surgery is used for smaller T2 lesions on the lower lip if simple closure produces an acceptable cosmetic result.
2. If a reconstructive surgical procedure is required, radiation therapy has the advantage of producing a relatively better functional and cosmetic result with intact skin and muscle innervation.
3. Radiation therapy may include external-beam and/or interstitial techniques as appropriate.

Standard treatment options:

1. Radiation therapy is usually selected for T2 lesions that have minimal infiltration to preserve speech and swallowing. Surgery is reserved for patients for whom radiation treatment failed. Neck dissection may be considered when primary brachytherapy is used.[2]
2. Deeply infiltrative lesions are best treated by surgery, radiation therapy, or a combination of both.

Standard treatment options:

1. Small T2 lesions (≤3 cm) are usually treated by radiation therapy.
2. Large T2 lesions (>3 cm) may be treated by surgery, radiation therapy, or a combination of these, if indicated. Radiation therapy is often used if the lesion involves the commissure. Surgery is often used if tumor invades the mandible or maxilla.

Standard treatment options:

1. For small T2 lesions (≤3 cm), surgery is often used if the lesion is attached to the periosteum, whereas radiation therapy is often used if the lesion encroaches on the tongue.
2. For large T2 lesions (>3 cm), surgery and radiation therapy are alternative methods of treatment, the choice of which depends primarily on the expected extent of disability from surgery.
3. External-beam radiation therapy with or without interstitial radiation therapy should be considered postoperatively for larger lesions.

Standard treatment options:

1. Small lesions may be treated by intraoral resection with or without a rim resection of bone and repaired with a split-thickness skin graft.
2. Radiation therapy may be used for small lesions, but results are generally better after surgery alone.

Standard treatment options:

1. For early lesions without detectable bone invasion, limited resection of the mandible is performed.
2. If limited resection is not feasible, radiation therapy may be used initially with surgery reserved for radiation failure.

Standard treatment options:

• Most lesions are treated by surgical resection with postoperative radiation therapy as appropriate. A small study showed that radiation therapy may be used effectively as the sole treatment modality.[3]

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II 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. Pernot M, Malissard L, Aletti P, et al.: Iridium-192 brachytherapy in the management of 147 T2N0 oral tongue carcinomas treated with irradiation alone: comparison of two treatment techniques. Radiother Oncol 23 (4): 223-8, 1992.  [PUBMED Abstract]
   
   
3. Yorozu A, Sykes AJ, Slevin NJ: Carcinoma of the hard palate treated with radiotherapy: a retrospective review of 31 cases. Oral Oncol 37 (6): 493-7, 2001.  [PUBMED Abstract]
   
   

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