Journal of Prevention and Treatment for Stomatological Diseases ›› 2018, Vol. 26 ›› Issue (5): 273-280.doi: 10.12016/j.issn.2096-1456.2018.05.001

• Expert Forum •     Next Articles

Research progress in comprehensive and sequential treatment of tongue squamous cell carcinoma

Chaobin PAN()   

  1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China
  • Received:2017-10-12 Revised:2017-12-18 Online:2018-05-20 Published:2018-08-30


Tongue squamous cell carcinoma (TSCC) is the most common oral cancer, with early lymph node metastasis and poor prognosis. Surgery is the primary treatment based on sequential therapy for TSCC. The treatment of TSCC has evolved gradually in the past few years and has exhibited a trend of standardization and personalization. Several aspects of TSCC treatment are discussed in this article, such as surgery, radiotherapy, chemotherapy, biotherapy, functional rehabilitation, psychological rehabilitative treatment, prognosis and follow-up systems. This article comments on the types of treatments and research progress for TSCC in China and abroad with the aim of providing a better understanding and references for clinical treatment.

Key words: Tongue squamous cell carcinoma, Surgery, Cervical lymph node dissection, Functional reconstruction, Radiotherapy, Chemotherapy, Biotherapy, Comprehensive and sequential treatment

CLC Number: 

  • R739.8

Figure 1

Coronal image of oral structures"

Figure 2

Preservation of the epiglottis when TSCC invades the tongue base"

Figure 3

Total glossectomy when TSCC invades the connective tissue in the preepiglottic space"

Table 1

Area selection and indications of supraomohyoid neck dissection"

清扫区域 适应证
SND(Ⅰ,Ⅱ,Ⅲ) 皮肤癌或颜面外侧癌
SND(Ⅰ,ⅡA,Ⅲ) 舌前部、牙槽嵴的肿瘤
SND(ⅠB,Ⅱ,Ⅲ) 舌后外侧部、磨牙后三角区肿瘤
[1] Siegel RL, Miller KD, Jemal A.Cancer statistics, 2015[J]. CA Cancer J Clin, 2015, 65(1): 5-29.
[2] Wade J, Smith H, Hankins M, et al.Conducting oral examinations for cancer in general practice: what are the barriers?[J]. Fam Pract, 2010, 27(1): 77-84.
[3] Warnakulasuriya S.Global epidemiology of oral and oropharyngeal cancer[J]. Oral Oncol, 2009, 45(4/5): 309-316.
[4] Parkin DM, Bray F, Ferlay J, et al.Global cancer statistics, 2002[J]. CA Cancer J Clin, 2005, 55(2): 74-108.
[5] St John Ma, Abemayor E, Wong DT.Recent new approaches to the treatment of head and neck cancer[J]. Anticancer Drugs, 2006, 17(4): 365-375.
[6] 温玉明, 华成舸, 王昌美, 等. 口腔癌的综合治疗[J]. 中华口腔医学杂志, 2003, 38(1): 73-75.
[7] MeierJd OD, Varvares M. Surgical margin determination in head and neck oncology:current clinical practice.The results of an International American Head and Neck Society Member Survey[J]. Head Neck, 2005, 27(11): 952-958.
[8] Mistry RC, Kumaran C.Post-resection mucosal margin shrinkage in oral cancer:quantification and significance[J]. J Surg Oncol, 2005, 91(2): 131-133.
[9] 张陈平. 舌癌的间室外科[J]. 中国癌症杂志, 2013, 23(12): 937-941.
[10] De Bree R, Van Der Waal I, De Bree E, et al. Management of adult soft tissue sarcomas of the head and neck[J]. Oral Oncol, 2010, 46(11): 786-790.
[11] Calabrese L, Giugliano G, Bruschini R, et al.Compartmental surgery in tongue tumours: description of a new surgical technique[J].Acta Otorhinolaryngol Ital, 2009, 29(5): 259-64.
[12] 张陈平. 口腔癌治疗规范的思考[J]. 中国肿瘤临床, 2010, 37(16): 905-907.
[13] 张陈平. 口腔癌临床及基础研究进展-关于舌癌治疗的几点建议[J]. 中国实用口腔科杂志, 2010, 3(7): 385-389.
[14] Lengelé B, Hamoir M, Scalliet P, et al.Anatomical bases for the radiological delineation of lymph node areas. major collecting trunks, head and neck[J]. Radiother Oncol, 2007, 85(1): 146-155.
[15] Abu-Ghanem S, Yehuda M, Carmel NN, et al.Elective neck dissection vs observation in early-stage squamous cell carcinoma of the oral tongue with no clinically apparent lymph node metastasis in the neck: a systematic review and meta-analysis[J]. JAMA Otolaryngol Head Neck Surg, 2016, 142(9): 857-865.
[16] D'cruz AK, Vaish R, Kapre N, et al. Elective versus therapeutic neck dissection in node-negative oral cancer[J]. N Engl J Med, 2015, 373(6): 521-529.
[17] Ferlito A, Robbins KT, Silver CE, et al.Classification of neck dissections: an evolving system[J]. Auris Nasus Larynx, 2009, 36(2): 127-134.
[18] Tarsitano A, Del Corso G, Tardio ML, et al.Tumor infiltration depth as predictor of nodal metastasis in early tongue squamous cell carcinoma[J]. J Oral Maxillofac Surg, 2016, 74(3): 523-527.
[19] Almangush A, Bello IO, Coletta RD, et al.For early-stage oral tongue cancer, depth of invasion and worst pattern of invasion are the strongest pathological predictors for locoregional recurrence and mortality[J]. Virchows Arch, 2015, 467(1): 39-46.
[20] Tai SK, Li WY, Yang MH, et al.Treatment for T1-2 oral squamous cell carcinoma with or without perineural invasion: neck dissection and postoperative adjuvant therapy[J]. Ann Surg Oncol, 2012, 19(6): 1995-2002.
[21] Chatzistefanou I, Lubek J, Markou K, et al.The role of neck dissection and postoperative adjuvant radiotherapy in cN0 patients with PNI-positive squamous cell carcinoma of the oral cavity[J]. Oral Oncol, 2014, 50(8): 753-758.
[22] Chen TC, Wang CP, Jy K, et al.The impact of perineural invasion and/or lymphovascular invasion on the survival of early-stage oral squamous cell carcinoma patients[J]. Ann Surg Oncol, 2013, 20(7): 2388-2395.
[23] Jerjes W, Upile T, Petrie A, et al.Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients[J]. Head Neck Oncol, 2010, 2: 9.
[24] 史剑杰, 罗志宾, 郭红英, 等. 面动脉瓣修复半舌缺损临床研究[J]. 广东牙病防治, 2012, 20(7): 369-372.
[25] Bokhari WA, Wang SJ.Tongue reconstruction: recent advances[J]. Curr Opin Otolaryngol Head Neck Surg, 2007, 15(4): 202-207.
[26] Song XM, Ye JH, Yuan Y, et al.Radial forearm free flap for reconstruction of a large defect after radical ablation of carcinoma of the tongue and floor of the mouth: some new modifications[J]. ORL J Otorhinolaryngol Relat Spec, 2010, 72(2): 106-112.
[27] 赵小朋, 潘朝斌, 黄洪章, 等. 舌癌根治同期前臂游离皮瓣或直接缝合修复半舌缺损的语音功能评价[J]. 中华整形外科杂志, 2008, 24(1): 6-9.
[28] Sahin B, Bulgurcu S, Arslan IB, et al.Prognostic factors of recurrence and neck metastasis in oral carcinomas[J]. Pak J Med Sci, 2016, 32(6): 1553-1556.
[29] Bernier J, Cooper JS, Pajak TF, et al.Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (22931) and RTOG ( 9501)[J]. Head Neck, 2005, 27(10): 843-850.
[30] Shrime MG, Gullane PJ, Dawson L, et al.The impact of adjuvant radiotherapy on survival in T1-2N1 squamous cell carcinoma of the oral cavity[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(3): 225-228.
[31] Peters LJ, Goepfert H, Ang KK, et al.Evaluation of the dose for postoperative radiation therapy of head and neck cancer: first report of a prospective randomized trial[J]. Int J Radiat Oncol Biol Phys, 1993, 26(1): 3-11.
[32] 邱蔚六, 郑家伟. 应重视口腔颌面部恶性肿瘤的综合序列治疗[J]. 中国口腔颌面外科杂志, 2005, 3(3): 179-182.
[33] Bourhis J, Sire C, Graff P, et al.Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial[J]. Lancet Oncol, 2012, 13(2): 145-153.
[34] Pignon JP, Bourhis J, Domenge C, et al.Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. meta-analysis of chemotherapy on head and neck cancer[J]. Lancet, 2000, 355(928): 949-955.
[35] Mohr C, Bohndorf W, Carstens J, et al.Preoperative radiochemotherapy and radical surgery in comparison with radical surgery alone. a prospective, multicentric, randomized DOSAK study of advanced squamous cell carcinoma of the oral cavity and the oropharynx (a 3-year follow-up)[J]. Int J Oral Maxillofac Surg, 1994, 23(3): 140-148.
[36] 钟来平, 孙坚, 郭伟, 等. 256例局部晚期口腔癌的生存分析[J]. 中国肿瘤临床, 2015, 42(4): 217-221.
[37] Adelstein D, Gillison ML, Pfister DG, et al.NCCN guidelines insights: head and neck cancers, version 2.2017[J]. J Natl Compr Canc Netw, 2017, 15(6): 761-770.
[38] Sultana J, Molla MR.New management strategies of oral tongue cancer in Bangladesh[J]. J Maxillofac Oral Surg, 2014, 13(4): 394-400.
[39] Ferris RL, Blumenschein G, Fayette J, et al.Nivolumab for recurrent squamous-cell carcinoma of the head and neck[J]. N Engl J Med, 2016, 375(19): 1856-1867.
[40] Chow LQM, Haddad R, Gupta S, et al.Antitumor activity of pembrolizumab in biomarker-unselected patients with recurrent and/or metastatic head and neck squamous cell carcinoma: results from the phase Ib keynote-012 expansion cohort[J]. J Clin Oncol, 2016, 34(32): 3838-3845.
[41] Haque S, Yellu M, Randhawa J, et al.Profile of pembrolizumab in the treatment of head and neck squamous cell carcinoma: design development and place in therapy[J]. Drug Des Devel Ther, 2017, 11: 2537-2549.
[42] Seiwert TY, Burtness B, Mehra R, et al.Safety and clinical activity of pembrolizumab for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (keynote-012): an open-label, multicentre, phase 1b trial[J]. Lancet Oncol, 2016, 17(7): 956-965.
[43] Dzioba A, Aalto D, Papadopoulos-Nydam G, et al.Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network[J]. J Otolaryngol Head Neck Surg, 2017, 46(1): 56.
[44] 黄卓珊, 张大明, 王友元, 等. 早期吞咽训练对舌癌术后吞咽障碍及生活质量的影响[J]. 中国口腔颌面外科杂志, 2017, 15(3): 249-253.
[45] 王祎, 叶茂昌, 王来平, 等. 舌癌根治性切除行前臂游离皮瓣修复重建的功能评价[J]. 口腔颌面外科杂志, 2016, 26(2): 105-109.
[46] 肖燕, 张沛沛, 李文鹿, 等. 口腔癌患者健康相关生活质量及其影响因素调查[J]. 口腔医学研究, 2016, 32(5): 478-482.
[47] Wolff KD,Follmann M, Nast A.The diagnosis and treatment of oral cavity cancer[J]. Dtsch Arztebl Int, 2012, 109(48): 829-835.
[48] Boysen M, Lövdal O, Winther F, et al.The value of follow-up in patients treated for squamous cell carcinoma of the head and neck[J]. Eur J Cancer, 1992, 28(2/3): 426-430.
[49] Flynn CJ, Khaouam N, Gardner S, et al.The value of periodic follow-up in the detection of recurrences after radical treatment in locally advanced head and neck cancer[J]. Clin Oncol (R CollRadiol), 2010, 22(10): 868-873.
[1] ZHONG qijian,JIN Tingting,PENG Yu,CHEN Weixiong,LI Jinsong. The effect of silencing the endoplasmic reticulum stress-related protein calnexin on the proliferation, invasion, and migration of tongue squamous cell carcinoma cells [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(8): 535-540.
[2] ZHANG Lin,TANG Yawen,WANG Jiantao,WANG Yan. Research progress on probiotics for the prevention and treatment of oral and gastrointestinal chemoradiotherapy mucositis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(8): 567-571.
[3] TANG Yawen,ZHANG Lin,YANG Xue,ZOU Jing,WANG Yan. Oral health management in children with acute lymphoblastic leukemia [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(8): 572-576.
[4] ZHANG Shuguang,YIN Xiteng,XU Wenguang,HAN Wei,LIU Zhe. Clinical analysis of 22 cases of lymphoepithelial carcinoma of parotid gland [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(6): 400-405.
[5] LI Ming,NAN Xinrong,YUAN Zhenying,TANG Zhangui. Accuracy analysis of MRI in the depth of invasion assessment of tongue squamous cell carcinoma [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(5): 322-327.
[6] LING Yunxiao,WANG Jiantao,WANG Yan. Research progress on biomarkers related to radiotherapy and/or chemotherapy-induced oral mucositis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(4): 260-266.
[7] JI Ling,WANG Jiahe,WANG Jiantao,Wang Yan. The role of Toll-like receptors in chemoradiotherapy-induced gastrointestinal mucositis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(2): 124-129.
[8] YANG Hui,WANG Xiang,ZHANG Lei,WANG Wenmei,DUAN Ning,LI Ruowei,ZHANG Miaomiao. Clinical analysis of 19 cases of oral mucosal malignant melanoma [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(12): 843-847.
[9] TANG Jianming,XIE Hongliang,LU Lu,LI Bohan,LIU Haonan,ZHANG Guoquan. Application of digital surgery in the reconstruction of mandibular composite defects with chimeric deep circumflex iliac artery perforator flap [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(11): 766-770.
[10] HUANG Xiangya,CAI Yanling,WEI Xi. Full-cycle management of endodontic microsurgery [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(10): 649-655.
[11] LUO Songyuan,WANG Bixia,WANG Xudong. Research progress on shared decision making in maxillofacial plastic surgery and aesthetic surgery [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(10): 701-705.
[12] SUN Zhongyi,CHEN Yiming,WANG Yi,JI Tong. 55 cases of perioperative mortality in oral maxillofacial head and neck cancer patients: a retrospective analysis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(9): 575-580.
[13] HUANG Jiacheng,WU Xiayi,CHEN Danying,TANG Zhiying,LIU Quan. Prevention of hematoma on the floor of the mouth during dental implant surgery in the anterior mandible [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(8): 519-524.
[14] CAO Shunshun,WANG Xiaolong,SHU Chuanji,SHAO Jianjie. Inhibitory effect of celecoxib on Cal-27 tongue squamous cell carcinoma cell proliferation [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(7): 427-432.
[15] TANG Yufei,LIU Zhenzhen,ZHOU Anqi,YU Hui,ZHANG Xinyuan,WANG Bin,MA Ziyan,XIANG Lin. Risk assessment and prevention in clinical diagnosis and treatment in implant surgery associated with systemic diseases [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(7): 453-457.
Full text



[1] ZHU Song-song, HU Jing. The application of distraction osteogenesis in the temporomandibular joint ankylosis and secondary dentofacial deformities[J]. journal1, 2016, 24(1): 6 -10 .
[2] XU Jing. The influence of the impacted mandibular third molar extraction on the distal periodontal tissue of the mandibular second molar[J]. journal1, 2016, 24(1): 11 -14 .
[3] ZHONG Jiang-long, PAN Ji-yang, CHEN Wei-liang. The evaluation of Eagle syndrome treatment by surgery combined with antidepressant therapy[J]. journal1, 2016, 24(1): 26 -28 .
[4] CHEN Xi, SUN Qin-zhou. The study of colorimetric board of porcelain fused to metal restoration for moderate to severe dental fluorosis[J]. journal1, 2016, 24(1): 33 -36 .
[5] OUYANG Ke-xiong1, LIANG Jun, ZOU Rui, LI Zhi-qiang, BAI Zhi-bao, PIAO Zheng-guo, ZHAO Jian-Jiang.. Ion Torrent RNA-Seq detection and analysis of the long non-coding RNA in tongue squamous cell carcinoma[J]. journal1, 2016, 24(1): 15 -19 .
[6] YU Pei, XUE Jing, ZHANG Xiao-wei, ZHENG Cang-shang. The influence of the roughness of zirconia ceramic surface on microbial attachment[J]. journal1, 2016, 24(1): 20 -25 .
[7] LIU Fang. Clinical assessment of two fissure sealant techniques in children’s dental caries prevention[J]. journal1, 2016, 24(1): 44 -45 .
[8] . [J]. journal1, 2016, 24(1): 49 -52 .
[9] LU Jian-rong, BAN Hua-jie, WANG Dai-you, ZHOU Hui-hui, LONG Ru, QIN Shu-hua. Clinical observation of sternocleidomastoid muscle flaps combined with artificial biological membrane reparing the defects after parotidectomy[J]. journal1, 2016, 24(1): 29 -32 .
[10] LI Bin, HE Xiao-ning, GAO Yuan, HU Yu-ping. Clinical analysis of pain after two kinds of apical stop preparation[J]. journal1, 2016, 24(1): 40 -43 .
This work is licensed under a Creative Commons Attribution 3.0 License.