Locally advanced oral cavity squamous cell carcinoma that would require mandibulectomy, but with no clinical or radiographic evidence of mandibular bone erosion — a setting in which mandibular preservation is the goal.
The prior step — induction chemotherapy with docetaxel, cisplatin, and fluorouracil — was intended to achieve sufficient tumor reduction to permit mandibular preservation. When that reduction target is not reached, this protocol defines the next course of action.
Following induction chemotherapy, the strategy involves a surgical approach aimed at preserving the mandible, with the extent of resection guided by the post-induction tumor volume, and subsequently followed by adjuvant concurrent treatment — an organ-preservation strategy in carefully selected cases.
DOI: 10.1200/EDBK_389810
In patients with locally advanced OSCC that would necessitate mandibulectomy, but no clinical and radiographic evidence of mandibular erosion, induction chemotherapy with three cycles of docetaxel + cisplatin + FU followed by an attempt at mandibular preservation surgery (possibly on the basis of the postinduction chemotherapy tumor volume) and adjuvant concurrent chemoradiotherapy may be a potential strategy for organ preservation, without compromising oncologic survival outcomes in carefully selected cases.
View source ↗