ABSTRACT
The oral cavity comprises the anterior two-thirds of the tongue, the floor of mouth, buccal mucosa, hard palate and gingivae (Fig. 10.1). Tumours of the lip are discussed in Chapter 9.
■ Curative radiotherapy for local disease For T1 and early T2 tumours, surgery and radiotherapy give equivalent local control rates but only if some or the entire radiation dose is given by brachytherapy. Fiveyear local control rates for T1 and T2 tumours are 75-95 per cent and 50-85 per cent, respectively. However, brachytherapy is often technically impossible (tumour is close to bone) or the necessary expertise unavailable. Therefore most T1 and T2 tumours of the oral cavity are treated with surgical excision as long as clear margins and good functional outcome can reasonably be expected. Where surgical excision is unlikely to achieve these outcomes, external beam radiation alone is used, most often in the case of a second primary tumour
radiotherapy alone can be used if a good functional outcome after surgery is unlikely. There is no proven role for radiotherapy for carcinoma in situ of the oral cavity. For tumours of the hard palate, brachytherapy is not technically possible and relative hypoxia in bone may reduce cure rates.
