Radiotherapy for oral cancer

Oral cancers occur at a relatively high rate in elderly patients. However, elderly patients often cannot undergo general anesthetization or surgery due to their declining physical condition. In addition, elderly patients who do undergo surgery for oral cancer occasionally develop problems with eating and swallowing or infectious disease. At the same time, oral cancers have been on the rise among patients in their 20s and 30s. For these younger patients, the aesthetic appearance of the oral region, as well as the full preservation of the abilities to eat, swallow, and enunciate, are especially important. Thus, in both elderly and younger patients, the preservation of aesthetic features and oral functions is critical when treating oral cancers. Conservative oral cancer treatment approaches include radiotherapy, chemotherapy, thermotherapy, immunotherapy, and gene therapy. In oral cancer cases in which surgery is not appropriate and a more conservative treatment must be used, radiotherapy is the most frequently chosen approach. Brachytherapy is often applied in early stage (stage I and II) and chemoradiotherapy in advanced stage (stage III and IV) oral cancers.The first part of this chapter presents the general method of radiotherapy for oral cancer and its potential side effects. The second portion of the chapter addresses the subject of brachytherapy, including low-dose rate and high-dose rate brachytherapy and mold therapy, and chemoradiotherapy.